Effect of cement augmentation combined with pedicle screw internal fixation in the treatment of thoracolumbar vertebral compression fractures with decreased bone density
Pu Chaoyao
Zhang Ye
Luo Wei
Ou Yunsheng
Abstract：Objective To compare the clinical effect of combined bone cement augmentation and pedicle screw internal fixation(PSF)versus PSF alone in the treatment of vertebral compression fractures(VCF)with de-creased bone density.Methods A retrospective analysis was conducted on 58 cases of osteopenic thoracolumbar VCF treated in our department from Jun.2021 to Jun.2023,with 32 males and 26 females.The injury mechanisms included falls(n=40),lifting of heavy objects(n=15),and unidentifiable causes(n=3).Based on different surgi-cal procedures,patients were divided into Group A(n=34,bone cement augmentation+PSF)and Group B(n=24,PSF alone).In Group A,there were 19 males and 15 females aged 51-70(mean 58.2)years,with the bone mineral density(BMD)T-score being(-1.76±0.27)SD;in Group B,there were 13 males and 11 females aged 49-64(mean 57.0)years,with the BMD T-score being(-1.75±0.21)SD.The following parameters were compared be-tween the two groups:operation time,intraoperative blood loss,length of hospital stay,lower back pain by VAS be-fore and 3 d after surgery and at last follow-up,Oswestry Disability Index(ODI),anterior vertebral height of the frac-tured vertebra and improvement rate,fractured vertebral collapse angles,and kyphotic angles of T10-L2.Complica-tions were also recorded.Results Patients were followed up for 12-15(mean 14.0)months.Patients in Group A exhibited longer operation time(min,97.6±5.1 vs.61.1±6.4),more intraoperative blood loss(mL,64.4±6.6 vs.44.3±4.2),and extended length of hospital stay(d,5.9±1.7 vs.4.8±1.6),revealing statistically significant differ-ences compared to Group B(all P<0.05).At last follow-up,the ODI showed no significant difference between the two groups(P>0.05),but Group A demonstrated significantly milder lower back pain(VAS,2.2±1.3 vs.3.2±1.3,and much superior radiographic outcomes in terms of anterior vertebral height(mm,24.4±1.4 vs.20.3±1.8)and improvement rate(105.9%±26.0%vs.68.5%±29.6%),fractured vertebral collapse angle(8.6°±2.3° vs.12.7°±3.2°),and T10-L2 kyphotic angle(11.5°±2.7° vs.14.1°±4.0°),all P<0.05.No significant difference was identified in the complication rate between the two groups(P>0.05).Conclusion Both PSF combined with bone cement augmentation and PSF alone can achieve satisfactory clinical outcomes in the treatment of patients with osteopenic VCF.However,the former is superior in improving vertebral height,thoracolumbar kyphotic angle,and fractured vertebral collapse angle.
Keywords：Thoracolumbar compression fracturesSurgical approachVertebroplastyInternal fixation
Publication Date：2025-07-15
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：8( 508-514,522 )