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Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition) ›› 2024, Vol. 10 ›› Issue (04): 193-201. doi: 10.3877/cma.j.issn.2096-0263.2024.04.001

• Spine •    

Correlation analysis of bone cement volume and dispersion and the clinical efficacy of PVP for OVCF

Xianli Feng1, Tong Gao2, Xishan Zhang3,()   

  1. 1. Department of Spine, The Second Affiliated Hospital of Shandong First Medical University, Taian 271000, China; Shandong Second Rehabilitation Hospital, Taian 271000, China
    2. Shandong Second Rehabilitation Hospital, Taian 271000, China
    3. Department of Spine, The Second Affiliated Hospital of Shandong First Medical University, Taian 271000, China
  • Received:2023-01-27 Online:2024-08-05 Published:2024-10-12
  • Contact: Xishan Zhang

Abstract:

Objective

To retrospectively analyze the correlation between the bone cement volume and dispersion and the efficacy of PVP in the treatment of osteoporotic vertebral compression fracture (OVCF), so as to provide some reference for surgeons.

Methods

Patients who were diagnosed with OVCF and underwent single vertebral PVP surgery in the Second Affiliated Hospital of Shandong First Medical University from March 2018 to September 2020 were included. Information such as age, gender, fracture segment, degree of vertebral compression of injured vertebrae, VAS score and ODI score before and after surgery, bone cement leakage, bone cement volume and distribution were collected. The bone cement leakage rate, the improvement of clinical efficacy, and the recovery of injured vertebral height were statistically analyzed according to bone cement volume and distribution.

Results

A total of 111 patients were included in this study, with 111 injured vertebrae. The low back pain of all the patients in the different groups was significantly relieved, and the VAS and ODI scores at each time point had no significant correlation with the volume and dispersion degree of bone cement. The incidence of vertebral body leakage in all injured vertebrae was 16.96%. With the increase of bone cement volume, the incidence of bone cement leakage gradually increased (P=0.019). The higher of the dispersion degree of bone cement, the incidence of bone cement penetration increased (P<0.001). The average recovery rate of injured vertebral height in all patients was (14.97±9.26)%. The recovery rate in the high-dose group was the largest (17.08±13.50)%, with a statistical difference (P=0.048). The proportion of recovery was the largest (19.32±9.48)% in the injured vertebra of diffusion grade Ⅲ(P=0.037). The incidence of adjacent vertebral fractures in all patients was 9.91%. The higher volume and dispersion degree of bone cement, the higher the incidence of adjacent vertebral fractures (P=0.010, P=0.035). No complications such as bone cement allergy and bone cement embolism occurred during follow-up.

Conclusion

PVP can effectively relieve preoperative symptoms and improve live quality for OVCF patients. The improvement of symptoms was not significantly related to the volume and dispersion degree of bone cement. The increase of the volume and dispersion degree of bone cement can improve the recovery ratio of injured vertebrae height, but also increase bone cement leakage and the incidence of adjacent vertebral fractures. The medium dose of bone cement volume (4-6 ml) and the grade II dispersion, can effectively improve the clinical symptoms and the height of the injured vertebra, maintain a low incidence of bone cement leakage and adjacent vertebral fractures.

Key words: Osteoporotic vertebral compression fracture, Percutaneous vertebroplasty, Bone cement volume, Degree of bone cement dispersion, Bone cement leakage

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