PVP And BFMCs In The Treatment Of Single Segment Posterior Wall Damage Short-and Medium-term Efficacy And Safety Of OVCF

Purpose: To investigate the effectiveness and safety of percutaneous vertebroplasty(PVP)and bone-filling mesh bag vertebral body reconstruction(BFMCs)in the treatment of osteoporotic vertebral compression fractures(OVCF)with posterior wall fractures.Methods: A retrospective analysis was conducted on 83 OVCF patients with posterior wall fractures who underwent vertebral body augmentation at the Spinal Disease Department of Chengdu Sports University Affiliated Hospital between January 2021 and December 2022.Among them,43 patients received PVP treatment and 40 patients received BFMCs treatment.Baseline data such as age and bone density were compared between the two groups to confirm that there were no significant differences.The effectiveness was evaluated based on the visual analogue scale(VAS)score,Oswestry Disability Index(ODI),Cobb angle,responsible vertebral body anterior height,and bone cement injection volume before surgery,and 1 day and 3 months after surgery.The safety was evaluated based on the operation time,intraoperative X-ray exposure times,and bone cement leakage rate.Results: All 83 patients completed the surgical treatment and 3-month follow-up successfully.Both groups showed significant improvement in VAS scores at postoperative day 1 and 3 months compared to preoperative scores(P <0.05),with no significant difference in VAS scores between the two groups(P >0.05).There was a significant difference in ODI index between the two groups before surgery and at 3months after surgery(P <0.05).Both groups showed significant improvement in Cobb angle and vertebral body anterior height after surgery compared to preoperative values(P <0.05),with no significant difference in the degree of improvement between the two groups(P>0.05).There was no significant difference in surgical time and intraoperative X-ray exposure frequency between the two groups(P >0.05),but the PVP group had a slight advantage over the BFMCs group.There was no significant difference in the amount of bone cement injection between the two groups(P >0.05).Regarding the bone cement leakage rate,it was 25.60%(11/43 cases)in the PVP group,with 2 cases of minor cement leakage into the spinal canal but without damage to spinal nerve function;and 7.50%(3/40 cases)in the BFMCs group,with no cement leakage into the spinal canal.Thus,the risk of bone cement leakage during surgery was significantly lower in the BFMCs group than in the PVP group(P <0.05).Conclusion: Both PVP and BFMCs can effectively and rapidly relieve pain,significantly improve the degree of physical activity limitation,and improve the degree of spinal kyphosis in patients with OVCFs with posterior vertebral body fractures.Good therapeutic effects can be maintained within 3 months after surgery for both procedures,and both can be used as treatment options for this condition.However,BFMCs have significant advantages in controlling bone cement leakage and have higher overall surgical safety.