Impact of Intravertebral Clefts Sclerosis on Percutaneous Vertebroplasty Efficacy in Osteoporotic Vertebral Compression Fractures.

Abstract

Objective: To investigate the effect of intravertebral cleft sclerosis on the efficacy of percutaneous vertebroplasty (PVP) in osteoporotic vertebral compression fractures (OVCFs).

Methods: We analyzed 68 OVCF patients with intravertebral clefts treated with PVP from January 2020 to June 2022. Patients were divided into 2 groups based on computed tomography findings: intravertebral clefts sclerosis (IVCs, 36 cases) and intravertebral clefts nonsclerosis (IVCns, 32 cases). Preoperative data included gender, age, bone mineral density, fractured vertebrae distribution, and disease duration. Excluding those with contraindications, all underwent PVP. Operation time, cement injection volume, leakage rate, and distribution patterns were recorded. Outcomes were evaluated using visual analog scale scores, oswestry disability index, anterior vertebral height, and Cobb angle preoperatively, and at 2 days and 1 year postoperatively.

Results: The IVCs group had a longer disease duration (P < 0.05). No significant differences in operation time, cement volume, or leakage rate were observed between groups (P > 0.05). Cement distribution was mass-like in IVCs and sponge-like in IVCns (P < 0.05). Both groups showed significant improvements postoperatively (P < 0.05), but IVCns had better recovery in anterior vertebral height, Cobb angle, and oswestry disability index (P < 0.05).

Conclusions: IVCs affect cement distribution and recovery outcomes, with IVCns achieving better results. Early treatment is advised for OVCF with intravertebral clefts.