A Comparison of High Viscosity Bone Cement and Low Viscosity Bone Cement Vertebroplasty for Severe Osteoporotic Vertebral Compression Fractures

Abstract：Objective To compare the clinical outcome and complications of high viscosity and low viscosity poly-methyl methacrylate(PMMA)bone cement percutaneous vertebroplasty(PVP)for severe osteoporotic vertebral compression fractures (OVCFs). Methods From December 2010 to December 2012,32 patients with severe OVCFs were randomly assigned to the group H using high viscosity cement(n = 14)or group L using low viscosity cement(n = 18). The clinical outcomes were as-sessed by the Visual Analogue Scale(VAS),Oswestry Disability Index(ODI),Short Form-36 General Health Survey(SF-36),kyphosis Cobb's angle,vertebral height,and complications. Results There were no significant differences between group H and group L in the gender ratios,age and involved vertebral bodies. Mean follow-up was 24. 5 months( range,18 ~ 42 months). No significant clinical complications or post-procedural clinical sequelae or new adjacent vertebral fractures were found. There was no statistical difference between the two groups according to the average surgery time,vertebrae and average injected cement volume,vertebrae(P ﹤ 0. 05). Of the 17 vertebrae in the group H,PVP was unipedicular in 4(23. 5% )cases and bipedicular in 1 3( 7 6 . 5 % ),whereas the procedure was unipedicular in 6( 2 7 . 3 % )cases and bipedicular in 1 6 (72. 7% )of 22 vertebrae in the group H,with no statistical difference(P ﹥ 0. 05). Significant improvement on the VAS,ODI, SF-36 scores,kyphosis Cobb's angle and vertebral height were noted in each group,and there were no significant differences between the 2 groups. Cement leakage was less in group H. Postoperative CT assessment identified cement leakage in 5 of 17 vertebraes in the group H(29. 4% )and in 15 of 22 vertebraes(68. 2% )in group L(P ﹤ 0. 05). All leakages were clinically silent and no neural compromise or pulmonary embolism was found. Conclusion The PVP using high viscosity bone cement can get the same clinical outcome and fewer complications compared with PVP using low viscosity bone cement.