Relationship Between Distribution Of Bone Cement And Outcome After PVP For Acute Osteoporotic Fractures Involving 1/3 Of The Vertebral Body With Fracture Line

Objective: In this study,we observed the outcome between the different distribution of bone cement,whose fracture line involved the middle 1/3 of the vertebral body,so as to provide a basis for treatment.Methods: From January 2017 to December 2018,164 patients with AOVCF who underwent PVP were analyzed retrospectively,all cases have fracture lines involving the middle 1/3 of the vertebral body.According to the preoperative and postoperative image data to determine fracture line location and used Mimics software measurement to assess bone cement dispersion distribution and the volume ratio of vertebral body fracture line area.The subjects were divided into three groups: group A: the bone cement dispersion distribution was good in the middle 1/3 of the vertebral body(the volume ratio of the bone cement dispersion distribution to the vertebral fracture line area > 75%).Group B: in the middle 1/3 of the vertebral body,the dispersion distribution of bone cement was better(the volume ratio of the dispersion distribution of bone cement to the fracture line area was 50%75%);C: there was no dispersion distribution of bone cement in the fracture line area,or although there was dispersion of bone cement in the fracture line area,the dispersion distribution of bone cement was poor(the volume ratio of the dispersion distribution of bone cement to the fracture line area was less than 50%).VAS,ODI,anterior vertebral height and local kyphosis Cobb angle were used to analyze the difference of curative effect among the three groups.Results: There were 43 patients in Group A,including 14 males(32.56%)with an average age of(65.44±5.70)years;67 patients in Group B,including 19 males(28.36%)with an average age of(66.46±4.96)years;and 54 patients in Group C,including 17 males(31.48%)with an average age of(66.52±5.39)years.There were no significant differences in baseline data such as age,gender,time from injury to operation,and BMI among the three groups(P>0.05).Although the VAS score,ODI score,anterior height of vertebral body and Cobb angle of local kyphosis in the three groups were significantly improved 1 day after operation,3 months after operation and the last follow-up(P<0.05),the VAS score and ODI score in group A and group B were significantly better than those in group C at 1 day after operation(P<0.05).Multiple linear regression analysis showed that group and time from injury to operation were closely related to the improvement of symptoms on the first day after operation.Conclusion: The distribution of bone cement in 1/3 of the vertebral body involved by the fracture line and the relative position of the fracture line will affect the short-term curative effect of the patients,but the long-term clinical results are similar.