Effects Of Osteoporotic Vertebral Compression Fractures After Unilateral Percutaneous Vertebroplasty On Bone Cement Distribution On Adjacent Vertebral Fractures

Objective:To predict and analyze the effect of bone cement distribution on adjacent vertebral fractures after unilateral puncture of PVP for single segment OVCFs.Methods:A retrospective review of patients with osteoporotic vertebral compression fractures(OVCF)treated in our department from June 2017 to June 2018 was performed.40 patients with complete data were selected according to the inclusion and exclusion criteria,including 16 males.There were 24 females,aged(71.4 ± 5.3)years,with a range of 64-75 years.The follow-up time was(19.48 ± 5.9)months,with a range of 12-24 months.They were divided into unilateral group(13 cases of 13 vertebrae)and bilateral group(27 cases of 27 vertebrae)according to whether the bone cement distribution on the postoperative X-ray film passed the midline of the vertebral body.The patients were divided into group A(8 cases with 8 vertebrae),group B(5 cases with 5 vertebrae),group C(11 cases with 11 vertebrae),and group D(16 cases with 16 vertebrae).Group,comparing visual analogue scale(VAS),oswestry disability index(ODI),Cobb angle and A,B,C,D The degree of change in the compression ratio of the anterior middle column and the angle between the upper and lower endplates of the four groups of affected vertebrae.Results:There were no significant differences in the age,height,weight,gender,bone mineral density T value,the proportion of thoracolumbar fractures,the time from onset to surgery,the duration of surgery,the intraoperative blood loss,and the amount of bone cement injected in the unilateral and bilateral groups(P> 0.05),the VAS score,ODI score,and Cobb angle at 1 year after surgery were significantly lower in both groups than before surgery,and the differences were statistically significant(P <0.001).The bone cement was unilaterally distributed and contacted with the upper and lower end plates.In group A,the compression degree of adjacent vertebrae was greater in one year after PVP(B = 1.857,OR = 6.407,95% CI = 1.899-21.613,P = 0.003),and the trend of fracture was greater.Conclusion:The distribution of bone cement in the unilateral and bilateral groups can achieve satisfactory clinical efficacy after PVP;the unilateral distribution of bone cement that does not cross the midline of the vertebral body and close to the upper and lower endplates of the vertebral body will cause the adjacent vertebrae to fracture after PVP.The trend is even greater.