The impact of different courses of osteoporotic vertebral compression fracture on the early efficacy of percutaneous vertebroplasty: a retrospective study - 25/12/24

Doi : 10.1016/j.otsr.2024.104088

Dawei Liang ^a,^b, Jia Pei ^b, Yongxiang Wang ^a,^c,⁎ , Ruoyan Pei ^d, Xiaohui Zhang ^b
^a Dalian Medical University, Dalian 116000, China
^b Luoyang Orthopedic-Traumatological Hospital of Henan Province (Henan Provincial Orthopedic Hospital), Zhengzhou 450000, China
^c Northern Jiangsu People's Hospital, Yangzhou 225001, China
^d Shenyang Pharmaceutical University, Shenyang 110000, China

^⁎Corresponding author.

En prensa. Pruebas corregidas por el autor. Disponible en línea desde el Wednesday 25 December 2024

Abstract

Introduction

Percutaneous vertebroplasty (PVP) is a frequently employed technique for treating osteoporotic vertebral compression fracture (OVCF). However, there is still controversy regarding whether PVP with different courses affects clinical efficacy. Therefore, this study aims to investigate the impact of different courses of OVCF on early clinical and radiological outcomes after PVP.

Hypothesis

OVCF with shorter course can obtain more satisfactory clinical efficacy and radiological results after PVP.

Materials and methods

A retrospective analysis was conducted on the clinical data of 100 patients undergoing PVP for OVCF. Patients were categorized into early group (n = 37, <2 weeks), intermediate group (n = 35, 2–4 weeks), and late group (n = 28, 4–6 weeks) according to the time from the occurrence of OVCF to undergoing PVP. The visual analogue scale (VAS) and oswestry disability index (ODI) were used to evaluate the clinical effect before, 1 day, and 12 months after surgery. Anterior vertebral height ratio (AVHR) and local kyphosis angle (LKA) were measured on plain radiographs to evaluate the radiographic changes. The cement volume, cement leakage, hospitalization time, new fractures, and outdoor activity (ODA) were compared among the three groups.

Results

Compared with preoperative, VAS and ODI of the three groups were significantly improved (p < 0.05). There was no difference in VAS at 1 day and 12 months after surgery among the three groups (3.3 vs. 3.2 vs. 3.2, 1.7 vs. 2.0 vs. 2.0, respectively). ODI was significantly better in the early and intermediate groups at 1 day and 12 months after surgery (33.49% vs. 32.37% vs. 35.24%, 31.86% vs. 30.73% vs. 34.56%, all p < 0.05), and without inter-group differences. Postoperative AVHR and LKA were improved in all three groups (p < 0.05). The improvement of AVHR and LKA at 1 day and 12 months after surgery was more significant in the early and intermediate groups (AVHR: 21.00% vs. 18.52% vs. 26.31%, 21.82% vs. 20.03% vs. 27.75%, LKA: 17.82º vs. 17.61º vs. 20.49º, 19.07º vs. 19.10º vs. 20.80º, all p < 0.05), and without inter-group differences. The cement volume in the late group was less (4.3 ml vs. 4.3 ml vs. 3.2 ml, p < 0.05), but there were no differences in cement leakage and new fractures. Patients in the late group had a longer hospitalization time (5.1d vs. 5.0d vs. 6.4d, p < 0.05) and poorer ODA (5/15/17 vs. 4/17/14 vs. 11/11/6, p < 0.05).

Conclusion

OVCF with a course of less than 4 weeks can recover partial vertebral height and improve local kyphosis after PVP. The clinical and radiological outcomes are better than course of more than 4 weeks. We recommend performing PVP within 4 weeks of the occurrence of OVCF.