Outcome comparison between unilateral and bilateral approaches in percutaneous kyphoplas-ty for osteoporotic vertebral compression fractures in the elderly
Cui Jinlei
Zhu Jun
Gao Junsheng
Wang Pei
Abstract：Objective To compare the efficacy of unilateral and bilateral approaches in percutaneousky-phoplasty(PKP)in elderly patients with osteoporotic vertebral compression fractures(OVCF).Methods A retro-spective analysis was conducted on 148 patients with OVCF who underwent PKP at our department from Oct.2022 to Sep.2024.There were 56 males and 92 females aged 60-88 years,with an average of 72.1 years.Patients were divided into unilateral(n=74)or bilateralapproach groups(n=74 for each)according to the surgical approaches.The peri-operative indicators,pain degrees,lumbar spine function,and postoperative adverse events like leakage,re-fracture,as well as pre-and post-operative imaging characteristics were analyzed.Results The two groups were comparable in terms of general data,injury course and bone density(all P＞0.05),but the unilateral approach group revealed much less operation time(min,35.2±10.3),intraoperative blood loss(mL,9.6±3.5),volume of bone ce-ment[mL,3(3,4)]and frequency of X-rays(11.6±5.7),than the bilateral approach groups[(56.6±11.3)min,(16.2±6.2)mL,5(4,6)mL,and 20.7±7.3].Repeated measures ANOVA revealed statistically significant time effects on imaging parameters(P＜0.05),but the inter-group and interaction effects showed no significant im-pact(P＞0.05).Generalized equation model analysis revealed a statistically significant effect of time point on pain intensity(P＜0.05),while inter-group and interaction effects showed no significant difference(P＞0.05).The ODI showed a similar trend.Analysis of preoperative and postoperative radiographic features revealed that patients with T12 vertebral compression fractures exhibited localized increased density and markedly reduced height on preopera-tive X-rays,with compression reaching approximately one-third of vertebral height.Postoperative follow-up X-ray demonstrated restoration of vertebral height.Patients with T7 vertebral compression fractures showed typical wedge-shaped deformity on preoperative X-rays,and postoperative follow-up X-ray indicated restoration of physiological ver-tebral curvature and improved wedge-shaped deformity.In the unilateral approach group,10 cases(13.5%)devel-oped adverse events,while the bilateral approach group revealed 14 cases(18.9%)of adverse events,with no statis-tically significant difference(95%CI:-0.174 to 0.066,P＞0.05).Conclusion Both unilateral and bilateral ap-proaches can effectively improve OVCF.The unilateral approach has advantages in improving perioperative relevant indicators.The surgical approach should be reasonably selected based on the individual differences to achieve the best treatment effect.
Keywords：Osteoporotic vertebral compression fracturesPercutaneous kyphoplastyUnilateral approachUilateral approach
Publication Date：2026-02-15
Online Publishing Date：2026-03-23(First online date of this platform, not the publication date of the document)
Pages：7( 105-111 )