| Does Distribution Pattern of Bone Cement during Percutaneous Vertebroplasty on Osteoporotic Vertebral Compression Fracture affect the Clinical and Radiological Outcomes ? |
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Jihun Han , Jinseo Yang , Yongjun Cho , Sukhyung Kang , Hyukjai Choi , Jinpyeong Jeon |
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Department of Neurosurgery, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea |
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| Abstract |
Objective
To assess the clinical effect and the radiological outcomes of percutaneous vertebroplasty by injection pattern of bone cement for the treatment of single level osteoporotic vertebral compression fracture at 12 months follow up.
Methods
Eighty patients with osteoporotic vertebral compression fractures were treated with vertebroplasty and were allocated four groups according to distribution types of bone cement by plain radiographs; Central, Central to paracentral, Paracentral, Diffuse. We investigated the clinical parameters, such as age, sex, T-score of bone densitometry, period between diagnosis and procedure, amount of PMMA (Polymethylmethacrylrate) injection, numeric rating scale (NRS) of back pain by reviewing the medical record and compared serial radiologic outcomes; compression ratio, and segmental kyphosis on fractured vertebra at preoperative, one day after vertebroplasty, and last 1 year follow up.
Results
We classified patients with four groups according to injection pattern of PMMA; Central (Group A, n=25), Central to paracentral (Group B, n=18), Paracentral (Group C, n=17), Diffuse (Group D, n=20). The four groups did not differ significantly in clinical characteristics and demographic data. Pain related to osteoporotic vertebral compression fracture was evaluated using a NRS. Significant statistical differences were found before and after in all groups. According to radiologic outcomes, postoperative vertebral body height and segmental kyphosis of fractured vertebra were improved in all groups. However, at last follow-up, these were worsen compared with postoperative conditions and there were no statistically differences between groups.
Conclusion
According to our radiologic results, in the process of vertebroplasty as the treatment for osteoporotic vertebral compression fracture, the injection pattern of bone cement for augmentation of collapse vertebral body do not affect clinical and radiologic outcomes at 12 months follow up. |
| Key Words:
Compression fracture, Osteoporosis, Kyphosis, Vertebroplasty, Kyphoplasty, Polymethyl Methacrylate |
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