Comparative Analysis Of The Clinical Research Of Unilateral And Bilateral Approaches For Percutaneous Kyphoplasty For Osteoporotic Vertebral Compression Fractures

Objective:To compare and analyze the clinical research of unilateral and bilateral percutaneous kyphoplasty(PKP)in the treatment of osteoporotic vertebral compression fracture(OVCFs).Methods: The article analysed 65 cases counting in 65 vertebra of the patients who took the percutaneous kyphoplasty for osteoporotic vertebral compression fracture from June 2018 to June 2019 and all those patients were followed up for at least 6 months.According to whether the operation was unilateral or bilateral,the patients were divided into unilateral group and bilateral group.30 diseased vertebrae were selected into unilateral group.9 of them were male with 9 diseased vertebrae while 21 of them are female with 21 diseased vertebrae,aged arranging from 62-96 years old,average of 76.3.Meanwhile another 35 cases were divided into bilateral group.Among them,11 were male with 11 diseased vertebrae and 24 were female with 24 diseased vertebrae,aged arranging from 61-92 years old,average of 74.2.The fracture vertebrae were all among T7-L4,all of which were diagnosed as new fresh compression fracture of osteoporosis vertebrae by symptoms,signs combined with bone density measurement,X-ray,CT,MRI or ect before operation.Each group was evaluated by clinical and imaging observation before and after operation.The evaluation indexes include: length of stray,lasts of operation,concealed in X-ray times during operation as well as amount of bone cement injection,VAS score,height recovery of anterior and middle vertebral bodies,Cobb angle correction and bone cement leakage,etc.Results: All the operations were accomplished successfully.No statistical difference in age,gender and days staying in hospital were shown between the unilateral group and the bilateral group.Both the unilateral and bilateral groups can relieve pain,restore the height of the anterior vertebrae and the height of the middle vertebrae,and correct kyphosis.There was no significant difference(P > 0.05)between the two groups in VAS decreasing,height recovery in the anterior and middle of vertebral body,and Cobb correction of kyphosis.The unilateral group has shorter operation time,fewer number of X-ray radiation,and less bone cement injection compared with bilateral group.There were significant differences(P <0.05)between the two groups in the operation time,the number of intraoperative X-ray,and The volume of bone cement injection;There were 3 cases of cement leakage in the unilateral group,2 cases of disc leakage,and 1 case of anterior vertebral leakage in the bilateral group.The leakage rate of bony cement was 10%(3 / 30)in unilateral group and 8.57%(3 / 35)in bilateral group(P >0.05).Conclusion: Percutaneous kyphoplasty through unilateral approach and bilateral approach were both effectively and safty towards treatment of osteoporotic vertebare compression fracture.Unilateral approach presented the advantages of less radiology、less trauma、less operative time、less injection of bony cement and etc.But the requirements and difficulties of unilateral puncture was comparatively higher than bilateral one.What’s more,the occurance of leakage of the bony cement didn’t increase.