Selection of puncture methods for osteoporotic vertebral compression fractures with different MRI features: comparison of the effects of unilateral puncture and bilateral puncture vertebroplasty
TU Hong-bo
JIN Yu-fei
ZHANG Liang
LIU Feng
Abstract：Objective To compare the clinical efficacy of unilateral puncture and bilateral puncture verte-broplasty in patients with different MRI features of osteoporotic vertebral compression fractures .Methods A total of 573 patients (743 vertebrae) who underwent vertebroplasty were treated with osteoporotic vertebral compression frac -tures during the period from Jan.2015 to Dec.2016.According to the different MRI features of osteoporotic vertebral compression fractures ,the 743 vertebrae were divided into three groups.There were significant fissure images or vacu-um signs in group A (133 vertebrae),the whole vertebral body showed high signal in group B (385 vertebrae),and part of the vertebral body showed high signal in group C (225 vertebrae).And they were treated by unilateral punc-ture or bilateral puncture vertebral surgery,respectively.The visual analogue scale score (VAS),bone cement infu-sion,bone cement dispersion,and bone cement leakage were compared.Results All the patients had postoperative pain relief significantly.There was no significant difference between the preoperative VAS scores (6.1 ±1.4,6.1 ± 1.3,6.0 ±1.3) and the postoperative VAS scores (2.3 ±1.1,2.2 ±1.1,2.3 ±1.2)of the three groups.There was no significant difference between unilateral puncture and bilateral puncture in VAS scores and bone cement infusion vol -ume.The bone cement infusion volume of unilateral puncture in group C was less than that in bilateral puncture ((4.6 ±1.2)mL vs.(5.4 ±1.4) mL).There was no significant difference of bone cement dispersion between unilateral puncture and bilateral puncture in group A.Bone cement dispersion in group B ,group C using unilateral puncture was worse than using bilateral puncture ((64 ±16)%,(49 ±16)% vs.(71 ±14)%,(56 ±14)%).A total of 97 verte-brae had bone cement leakage ,and the leakage rate was 13.1%.Bone cement leakage in group A using bilateral puncture was higher than using unilateral puncture (28.6% vs.25.0%),and in the group C was just the opposite (10.8%vs.7.0%),while having no difference in group B(11.7%vs.11.2%).Conclusion Whether it is unilat-eral puncture or bilateral puncture,vertebroplasty is an effective method for the treatment of osteoporotic vertebral com -pression fractures.Unilateral puncture or bilateral puncture can be chosen to get better bone cement dispersion and less bone cement leakage preoperatively on the base of MRI features.
Keywords：vertebral fracturesosteoporosisvertebroplastypunctureimaging
Publication Date：2018-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 427-430 )