Application of temperature control combined with target perfusion technology of bone cement in percutaneous vertebroplasty

LI Zheng-xing; HAN Ting-liang; TIAN Lin; SUN Zhao-jie; DONG Song-lin; MA Yong

doi:10.3969/j.issn.2095-252X.2025.04.002

Abstract：Objective To compare the temperature control of bone cement combined with targeted perfusion technology with that of traditional bone cement perfusion technology,and to explore the therapeutic efficacy of its application in percutaneous vertebroplasty for the treatment of osteoporotic thoracolumbar compression fractures.Methods A retrospective cohort study was conducted to analyze the clinical data of 93 patients with osteoporotic thoracolumbar vertebral compression fractures admitted to Yancheng Traditional Chinese Medicine Hospital affiliated with Nanjing University of Chinese Medicine from January 2021 to December 2022.The cohort included 18 males and 75 females,aged 52-96 years(mean,74.49±0.99 years).All patients were treated with percutaneous vertebroplasty;45 cases underwent temperature control combined with targeted perfusion technology(combined group),and 48 cases underwent traditional puncture injection(traditional group).We compared surgical time,total area of bone cement diffusion ratio,bone cement leakage rate,incidence of adjacent vertebral fractures,as well as the visual analog scale(VAS),Oswestry functional impairment index(ODI),anterior vertebral compression rate,Cobb's angle,and other conditions before and after surgery and at the last follow-up between two groups.Results All patients were followed up for 12-20 months(mean:15.76±0.27 months).There was no statistically significant difference(P>0.05)in surgical time,anterior vertebral compression rate,Cobb's angle,VAS,and ODI between the two groups of patients before and 1 day after surgery.At the last follow-up,the VAS score of the combined group was 2(1,2)points,which was lower than the traditional group's 2(1,3)points(P<0.05).At the last follow-up,the ODI of the combined group was(16.64±0.98)%,which was lower than that of the traditional group(20.37±1.38)%(P<0.01).At the last follow-up,the anterior vertebral compression rate of the combined group was(19.36±1.73)%,which was lower than that of the traditional group(25.72±1.76)%(P<0.01).At the last follow-up,the Cobb's angle of the affected vertebrae in the combined group was(8.92±0.58)°,which was lower than that in the traditional group(10.26±0.54)°(P<0.05).The ratio of the total diffusion area of bone cement in the combined group(0.64±0.01)was significantly higher than that in the traditional group(0.57±0.01)(P<0.01).Three cases of bone cement leakage occurred in the combined group[6.7%(3/45)],while 13 cases of bone cement leakage occurred in the traditional group[27.1%(13/48)](P<0.05).During the follow-up period,one case of adjacent vertebral fracture occurred in the combined group[2.2%(1/45)],while eight cases of adjacent vertebral fracture occurred in the traditional group[16.7%(8/48)](P<0.05).Conclusions The use of bone cement temperature control combined with target infusion technology and traditional puncture injection technology in percutaneous vertebroplasty can achieve satisfactory therapeutic effects in the treatment of osteoporotic thoracolumbar compression fractures.However,the former has the advantages of reducing the anterior vertebral height and Cobb's angle loss after percutaneous vertebroplasty,reducing postoperative chronic back pain and functional impairment index,and decreasing the bone cement leakage rate and incidence of adjacent vertebral fractures.