Comparison Of Unilateral And Bilateral Puncture During Percutaneous Vertebroplasty In Elderly Women

Objective: To compare the effects of single and bilateral Percutaneous Vertebroplasty PVP on vertebral height and postoperative outcomes in the treatment of thoracolumbar osteoporotic compression fractures in elderly women.Methods: From January 2016 to January 2020,female patients who received PVP surgery in the Spinal Surgery Department of Yijishan Hospital of Wannan Medical College for osteoporotic compression fractures of some thoracolumbar vertebral bodies(T12,L1)were selected.The patients were aged 65-85 years old,with an average age of(73.53±6.37)years old.A total of 73 patients were selected,including 24 patients with unilateral PVP1 and 15 patients with bilateral PVP2.T12 Unilateral PVP19 patients,bilateral 15 patients.Vertebral height measurement: The anterior edge,midpoint and posterior edge of the vertebral body before and after PVP surgery were measured by thoracolumbar lateral X-ray.Effectivity assessment: Patients were evaluated by Visual Analogue Score VAS and The Oswestry Disability Index ODI before and after surgery.Finally,SPSS 18.0(IBM,USA)software was used for statistical analysis.Results: Comparison of vertebral body height before and after L1 surgery: anterior edge(1.82±0.36)cm,midpoint(1.90±0.29)cm,posterior edge(2.95±0.26)cm before unilateral surgery;Unilateral surgery: anterior edge(2.20±0.37)cm,midpoint(2.29±0.30)cm,posterior edge(3.17±0.28)cm.Paired t test was used for vertebral height between the two groups,and the difference was statistically significant(P<0.001).Bilateral preoperation: anterior edge(1.89±0.35)cm,midpoint(1.93±0.32)cm,posterior edge(2.85±0.33)cm;Bilateral surgery: anterior edge(2.24±0.40)cm,midpoint(2.23±0.31)cm,posterior edge(3.03±0.29)cm.Paired t test was used for vertebral height between the two groups,and the difference was statistically significant(P<0.001).Height difference(postoperative height--preoperative height = height difference),unilateral: leading edge 1.32cm,midpoint 0.35cm,posterior edge 0.18cm;Bilateral: leading edge1.06cm,midpoint 0.28cm,trailing edge 0.06cm.The height difference between the two groups was tested by rank sum test of independent samples of the two groups,and the difference was not statistically significant(P>0.05).Comparison of vertebral body height before and after T12 surgery:anterior edge(1.77±0.34)cm,midpoint(1.85±0.35)cm,posterior edge(2.65±0.31)cm before unilateral surgery;Unilateral surgery: anterior edge(2.17±0.32)cm,midpoint(2.23±0.30)cm,posterior edge(2.85±0.32)cm.Paired t test was used for vertebral height between the two groups,and the difference was statistically significant(P<0.001).Bilateral preoperation: anterior edge(1.91±0.46)cm,midpoint(1.97±0.46)cm,posterior edge(2.75±0.21)cm;Bilateral surgery: anterior edge(2.24±0.30)cm,midpoint(2.33±0.27)cm,posterior edge(2.92±0.14)cm.Paired t test was used for vertebral height between the two groups,and the difference was statistically significant(P<0.001).Height difference(postoperative height--preoperative height=height difference),unilateral: leading edge 0.37cm,midpoint 0.44cm,posterior edge 0.16cm;Bilateral: leading edge0.87cm,midpoint 0.86cm,trailing edge 0.16cm.Height difference between the two groups was tested by rank sum test of two independent samples,and the unilateral and bilateral height difference of the leading edge and midpoint respectively was statistically significant(P<0.001).L1 VAS difference(preoperative VAS score--postoperative VAS score =VAS difference): unilateral(4.68±0.92),bilateral(4.80±0.86).Group t test was used for data of the two groups,and the difference was not statistically significant(P>0.05).L1 ODI difference: Unilateral(34.17±7.93)and bilateral(31.85±7.86).Group t test was used for data of the two groups,and the difference was not statistically significant(P>0.05).T12 VAS difference(preoperative VAS score--postoperative VAS score =VAS difference): unilateral(5.00±0.94),bilateral(5.07±1.03).Group t test was used for data between the two groups,and the difference was not statistically significant(P>0.05).T12 ODI difference: unilateral(36.02±6.65)and bilateral(37.33±8.49).Group t test was used for data of the two groups,and the difference was not statistically significant(P>0.05).Conclusion: Percutaneous vertebroplasty,whether unilateral or bilateral puncture,can achieve good surgical results for early patients with OVCFS,so as to enable elderly female patients to get out of bed early after surgery and avoid complications caused by long-term bed rest.The height of the diseased vertebra can be restored to different degrees by two kinds of puncture methods.Among them,there was no significant difference in the height of the vertebral body between the two puncture methods,but the recovery degree of the height of the leading edge and middle part of T12 was greater on both sides than on one side.Although the height recovery was different,it had no effect on the early surgical effect.There was no significant difference in early operative outcomes between the two methods.