Guobing Hao, Zhenchuan Han, Nan Zhang, Kun Liu, Diyu Song, Shuming Zhang, Lin Qiao, Zexing Zhu
{"title":"Efficacy of Percutaneous Vertebroplasty Using Cross-Puncture in the Treatment of Genant Grade 0–1 Osteoporotic Vertebral Compression Fractures","authors":"Guobing Hao, Zhenchuan Han, Nan Zhang, Kun Liu, Diyu Song, Shuming Zhang, Lin Qiao, Zexing Zhu","doi":"10.1016/j.wneu.2024.123633","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Percutaneous vertebroplasty (PVP) is a common surgical method for osteoporotic vertebral compression fractures (OVCFs). The puncture method and location of the puncture needle can directly affect bone cement distribution in the vertebra. This retrospective study aimed to compare the clinical efficacy and safety of PVP using the cross-puncture and bilateral conventional puncture for the treatment of Genant grade 0–1 OVCFs.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 98 patients who underwent PVP in our department between January 2019 and April 2023, including 50 and 48 treated with the cross-puncture (group A) and bilateral conventional puncture (group B), respectively. Operation time (minutes), bone cement injection volume (mL), bone cement leakage rate, bone cement classification, and related complications were compared between the groups. The visual analog scale, Oswestry Disability Index, heights of the anterior and midline of the injured vertebrae, and Cobb angle were compared preoperatively and at the follow-up. Excellent and good operation rates were evaluated using the modified Macnab criteria.</div></div><div><h3>Results</h3><div>The bone cement leakage rate in group B (25%) was higher than that in group A (8%) (<em>P</em> < 0.05). However, the injection amount of bone cement in group A (5.47 ± 0.72 mL) was significantly higher than that in group B (4.43 ± 0.64 mL) (<em>P</em> < 0.001). The bone cement distribution grades in group A (40 cases of grade 3) were significantly better than those in group B (0 cases of grade 3) (<em>P</em> < 0.001). Compared with preoperative values, the visual analog scale and Oswestry Disability Index scores at each follow-up significantly decreased, anterior and midline heights of the injured vertebrae significantly increased, and Cobb angle significantly decreased in both groups (<em>P</em> < 0.001). The complication rate in group A (0%) was significantly lower than that in group B (10.42%) (<em>P</em> < 0.05). According to the modified Macnab standard, the excellent and good ratings in group A (96%) were significantly higher than those in group B (62.5%) (<em>P</em> < 0.001).</div></div><div><h3>Conclusions</h3><div>Cross-puncture and bilateral conventional puncture were both effective methods for the treatment of Genant grade 0–1 OVCFs. However, the cross-puncture was more advantageous in terms of the bone cement leakage rate, amount of bone cement injected, bone cement distribution grade, and complications.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"195 ","pages":"Article 123633"},"PeriodicalIF":1.9000,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"World neurosurgery","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1878875024020837","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background
Percutaneous vertebroplasty (PVP) is a common surgical method for osteoporotic vertebral compression fractures (OVCFs). The puncture method and location of the puncture needle can directly affect bone cement distribution in the vertebra. This retrospective study aimed to compare the clinical efficacy and safety of PVP using the cross-puncture and bilateral conventional puncture for the treatment of Genant grade 0–1 OVCFs.
Methods
We retrospectively analyzed 98 patients who underwent PVP in our department between January 2019 and April 2023, including 50 and 48 treated with the cross-puncture (group A) and bilateral conventional puncture (group B), respectively. Operation time (minutes), bone cement injection volume (mL), bone cement leakage rate, bone cement classification, and related complications were compared between the groups. The visual analog scale, Oswestry Disability Index, heights of the anterior and midline of the injured vertebrae, and Cobb angle were compared preoperatively and at the follow-up. Excellent and good operation rates were evaluated using the modified Macnab criteria.
Results
The bone cement leakage rate in group B (25%) was higher than that in group A (8%) (P < 0.05). However, the injection amount of bone cement in group A (5.47 ± 0.72 mL) was significantly higher than that in group B (4.43 ± 0.64 mL) (P < 0.001). The bone cement distribution grades in group A (40 cases of grade 3) were significantly better than those in group B (0 cases of grade 3) (P < 0.001). Compared with preoperative values, the visual analog scale and Oswestry Disability Index scores at each follow-up significantly decreased, anterior and midline heights of the injured vertebrae significantly increased, and Cobb angle significantly decreased in both groups (P < 0.001). The complication rate in group A (0%) was significantly lower than that in group B (10.42%) (P < 0.05). According to the modified Macnab standard, the excellent and good ratings in group A (96%) were significantly higher than those in group B (62.5%) (P < 0.001).
Conclusions
Cross-puncture and bilateral conventional puncture were both effective methods for the treatment of Genant grade 0–1 OVCFs. However, the cross-puncture was more advantageous in terms of the bone cement leakage rate, amount of bone cement injected, bone cement distribution grade, and complications.
期刊介绍：
World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review.
The journal''s mission is to:
-To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care.
-To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide.
-To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients.
Topics to be addressed in World Neurosurgery include: EDUCATION, ECONOMICS, RESEARCH, POLITICS, HISTORY, CULTURE, CLINICAL SCIENCE, LABORATORY SCIENCE, TECHNOLOGY, OPERATIVE TECHNIQUES, CLINICAL IMAGES, VIDEOS
京公网安备 11010802042870号
京ICP备2023020795号-1
分享
求助内容：
应助结果提醒方式：
扫码关注我们
