Can an unipedicular approach replace bipedicular percutaneous vertebroplasty for osteoporotic vertebral compression fracture?

OBJECTIVE To compare outcomes of unipedicular versus bipedicular approach for percutaneous vertebroplasty for the treatment of thoracolumbar acute osteoporotic vertebral compression fracture (AOVCF). METHOD From November 2014 to September 2015, 382 patients with AOVCF were randomly assigned to the unipedicular and bipedicular groups. Clinical outcomes and complications were compared. RESULTS Both groups were comparable with respect to bone cement leakage and adjacent vertebral fractures (P> 0.05). Although the bipedicular approach was found to be superior in terms of reduction of kyphosis and loss of reduction, frequency of x-ray fluoroscopy, VAS and ODI scores, the volume of cement injected and operating time, the between-group differences were not statistically significant (P> 0.05). Nerve root stimulation was more frequent in the unipedicular group (P< 0.05). CONCLUSIONS The clinical and radiological outcomes of both procedures were comparable. The unipedicular approach was associated with more nerve root stimulation.

[1]  Lianghu Zhang,et al.  Unipedicular versus bipedicular percutaneous vertebroplasty for osteoporotic vertebral compression fractures: a prospective randomized study , 2015, BMC Musculoskeletal Disorders.

[2]  X. Gu,et al.  Unilateral or Bilateral Percutaneous Vertebroplasty for Acute Osteoporotic Vertebral Fracture: A Prospective Study , 2015, Journal of spinal disorders & techniques.

[3]  D. Hao,et al.  A Comparison Between Unilateral Transverse Process-Pedicle and Bilateral Puncture Techniques in Percutaneous Kyphoplasty , 2014, Spine.

[4]  Yanzheng Gao,et al.  Significantly reduced radiation dose to operators during percutaneous vertebroplasty using a new cement delivery device , 2014, BMC Musculoskeletal Disorders.

[5]  J. Ko,et al.  Multiple pulmonary cement embolism after percutaneous vertebroplasty. , 2013, QJM : monthly journal of the Association of Physicians.

[6]  Yong Gu,et al.  Comparative Study of Kyphoplasty for Chronic Painful Osteoporotic Vertebral Compression Fractures via Unipedicular Versus Bipedicular Approach , 2011, Journal of spinal disorders & techniques.

[7]  A. V. van Erkel,et al.  A Clinical Comparative Study on Low Versus Medium Viscosity PolyMethylMetAcrylate Bone Cement in Percutaneous Vertebroplasty: Viscosity Associated With Cement Leakage , 2010, Spine.

[8]  B A Georgy,et al.  Clinical Experience with High-Viscosity Cements for Percutaneous Vertebral Body Augmentation: Occurrence, Degree, and Location of Cement Leakage Compared with Kyphoplasty , 2010, American Journal of Neuroradiology.

[9]  M. Aebi.  Classification of thoracolumbar fractures and dislocations , 2010, European Spine Journal.

[10]  Y. Oh,et al.  Clinical and radiological comparison of unipedicular versus bipedicular balloon kyphoplasty for the treatment of vertebral compression fractures , 2009, Osteoporosis International.

[11]  C. Roux,et al.  Spinal deformity index (SDI) is a good predictor of incident vertebral fractures , 2009, Osteoporosis International.

[12]  H. Chung,et al.  Comparative study of balloon kyphoplasty with unilateral versus bilateral approach in osteoporotic vertebral compression fractures , 2008, International Orthopaedics.

[13]  K. Takizawa,et al.  Unilateral transpedicular percutaneous vertebroplasty using puncture simulation , 2006, Radiation Medicine.

[14]  Q. Dai,et al.  Biomechanical Comparison of Unipedicular Versus Bipedicular Kyphoplasty , 2005, Spine.

[15]  D. Kallmes,et al.  Unilateral transpedicular percutaneous vertebroplasty: initial experience. , 2002, Radiology.

[16]  A. Levine,et al.  Biomechanical efficacy of unipedicular versus bipedicular vertebroplasty for the management of osteoporotic compression fractures. , 1999, Spine.

[17]  H. Deramond,et al.  Percutaneous vertebroplasty with polymethylmethacrylate. Technique, indications, and results. , 1998, Radiologic clinics of North America.

[18]  H. Deramond,et al.  [Preliminary note on the treatment of vertebral angioma by percutaneous acrylic vertebroplasty]. , 1987, Neuro-Chirurgie.

[19]  Y. Inoue,et al.  Thin section CT of normal pituitary glands. , 1985, Radiation Medicine.