Unilateral Dual-Plane Puncture Percutaneous Vertebroplasty Reduces Re-Collapse in Osteoporotic Vertebral Compression Fractures by Advancing Cement Delivery.

Abstract

Purpose: Evaluate the efficacy of a novel unilateral dual-plane puncture technique in improving bone cement distribution and reducing vertebral re-collapse following percutaneous vertebroplasty (PVP) for osteoporotic vertebral compression fractures (OVCFs). By introducing the novel unilateral dual-plane puncture technique, this study aims to improve cement distribution, reduce the incidence of re-collapse, and enhance long-term clinical outcomes for patients suffering from OVCFs.

Methods: This is a randomized trial conducted from April 2021 to December 2022, enrolling 145 patients diagnosed with OVCFs. Patients were allocated into either traditional or unilateral dual-plane puncture groups. Bone cement distribution, vertebral height, and segmental kyphotic angle were measured through postoperative x-ray, while clinical outcomes were evaluated using the Visual Analog Scale (VAS) and the Oswestry Disability Index (ODI). Statistical analysis was performed using the Mann-Whitney U test and independent samples t test for continuous variables, and chi-square or Fisher's exact test for categorical variables.

Results: The unilateral dual-plane puncture technique notably augmented bone cement contact with both superior and inferior endplates compared to conventional methods, achieving rates of 64.86% versus 40.85% (p < 0.001). This contributed to a significant reduction in the incidence of vertebral re-collapse within the first year post-operation: 18.92% in the unilateral dual-plane group as opposed to 42.25% in the traditional group (p < 0.001). Furthermore, the unilateral dual-plane group exhibited markedly superior long-term efficacy, evidenced by mean VAS and ODI scores of 1.26 and 28.58, respectively, in comparison to 2.03 and 32.45 in the traditional group.

Conclusions: The unilateral dual-plane puncture technique advances bone cement distribution within the vertebra, thereby reducing the risk of vertebral re-collapse following PVP surgery and improving long-term clinical outcomes for patients with OVCFs.