Unilateral Vertebroplasty in the Treatment of Osteoporotic Vertebral Compression Fractures: Effects of Cement Amount on Pain, Coronal Balance, and New Compression Fracture Formation.

Abstract

Aim: To evaluate the impact of the volume of cement injected during unilateral percutaneous vertebroplasty (PVP) on the occurrence of new fractures, as well as its effect on coronal balance and pain management in patients with osteoporotic vertebral compression fractures (OVCFs).

Material and methods: A total of 64 OVCF patients who underwent unilateral PVP were included in this study, and categorized into two groups based on the amount of cement injected during the procedure. The first group comprised 34 patients with an injected cement volume of ?3 ml (37 levels), while the second group comprised the rest with an injected cement volume of > 3 ml (39 levels). Coronal balance changes were evaluated immediately after the procedure and at 6 months post-operatively. The incidence and timing of new fractures following the initial vertebroplasty were also analyzed.

Results: No statistically significant difference was found between the two groups regarding improvement in pre- and postoperative Visual Analog Scale scores. Similarly, no significant difference was observed in the Cobb angle measurements between the groups. New fractures developed in 1 patient from the small amount cement augmented group, and in 7 patients from the large amount cement augmented group, revealing a statistically significant difference in the incidence of new fracture formation.

Conclusion: A higher volume of cement injection during PVP appears to be a risk factor for the increased incidence of new fractures at other vertebral levels in patients with OVCF and these fractures typically occur within six months following the initial procedure. However, the volume of cement did not significantly affect clinical outcomes such as pain relief, mobility, or the restoration of coronal alignment.