Comparisons Of Treatment Of Osteoporotic Vertebral Compressive Fractures By Bone Cement Injection In Different Region Of Vertebral Body

Objective: To compare the effect of percutaneous vertebroplasty through vertebralvein concentration areas and sparse area in the treatment of osteoporotic spinalcompressive fractures and the rate of bone cement leakage, and investigate relativelysafe area for bone cement injection and reduce leakage of bone cement.Methods: During March2012to March2014,100cases of single mild osteoporoticvertebral compression fractures in our hospital that treated with PVP wereretrospectively studied. According to the anatomical features of vertebral venous, thevertebral body can be divided into venous concentration area in the middle one thirdof the vertebral body where venous were concentrated distributed, and venous sparsearea in upper and lower one thirds of the vertebral body where less and thin vertebralvein were distributed. The puncture needles of52cases located in the venousconcentration area (group A), while the puncture needles of other48cases werelocated in the vertebral venous sparse area (group B). Before and after surgery, theVAS scores, the anterior height of the injured vertebra and the upper and lower ones,and the Cobb’s angle of injured vertebra were recorded. The volume of bone cementinjected also documented. The AP and lateral view of X-ray was taken1day afteroperation. The rate of bone cement leakage was calculated and analyzed.Results:(1) There was significant difference between VAS of before treatment and24hours after treatment (P<0.01); there was no statistically significant differencebetween VAS score of24hours and6months after treatment (P>0.05).(2) The bonecement injection volume in group A was4.3±0.7ml and3.9±0.2ml group B, thedifference between these groups were statistically significant (P<0.05).(3) There wasno significant difference between group A and B in the recovery of the anterior heightof the injured vertebral body and the recovery of Cobb’s Angle (P>0.05).(4) The totalbone cement leakage rate of group A and group B was44.2%and37.5%, thedifference was statistically significant (p<0.05). The paravertebral veins leakage ratewas17.3%vs12.5%, the difference was statistically significant (p<0.05). There was no statistically significant difference between group A and B in soft tissue leakage rate,puncture tract leakage rate, spinal canal leakage rate, and intervertebral disc leakagerate (p>0.05).Conclusions:1. Bone cement injection in dense or spare area of vertebral body cancontribute to pain relief, restore vertebral body height and correct kyphosis.2. Although less volume of cement was injected into sparse area of VB than condensearea, there was no significant different in clinical results between these two groups.The bone cement leakage in group A was significantly lower than group B, indicatethat filling of cement in sparse area could reduce the cement leakage, and the sparsearea is probably a relative safe area for PVP.