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Abstract：
BACKGROUND: Unipedicular and bipedicular approaches for percutaneous kyphoplasty are reportedly both effective in treating osteoporotic vertebral compression fractures (OVCFs). However, most studies have reported thoracolumbar fractures, with few reports describing the treatment of the lower lumbar spine. Here, we compared the clinical and radiological results of unipedicular and bipedicular approaches for percutaneous kyphoplasty for treating osteoporotic vertebral compression fractures.
METHODS: We retrospectively reviewed the records of 160 patients who underwent percutaneous kyphoplasty for lower lumbar (L3-L5) osteoporotic vertebral compression fractures between January 2016 and January 2020. Patient characteristics, surgical outcomes, operation time, blood loss, clinical and radiological features, and complications were compared between two groups. Cement leakage, height restoration, and cement distribution were calculated from the radiographs. Visual pain analog scale (VAS) and Oswestry Disability Index (ODI) were calculated before surgery, immediately post-surgery, and 2 years after surgery.
RESULTS: The mean age, sex, body mass index, injury time, segmental distribution, and morphological classification of fractures before surgery did not differ significantly between the groups. The results showed significant improvements in the VAS score, ODI score, and vertebral height restoration in each group (p < 0.05), with no significant differences between the two groups (p > 0.05). The mean operation time and extent of blood loss were lower in the unipedicular group than those in the bipedicular group (p < 0.05). Different types of bone cement leakage were observed in both groups. Leakage rate was higher in the bipedicular group than in the unipedicular group. Patients in the bipedicular group showed greater improvement in bone cement distribution than those in the unipedicular group (p < 0.05).
CONCLUSIONS: The clinical and radiological results of unipedicular percutaneous kyphoplasty for treating osteoporotic vertebral compression fractures in the lower lumbar region were similar to those of bipedicular percutaneous kyphoplasty. However, the unipedicular approach resulted in shorter surgical time, less blood loss, and less bone cement leakage. Thus, the unipedicular approach may be preferable owing to its several advantages.
METHODS: We retrospectively reviewed the records of 160 patients who underwent percutaneous kyphoplasty for lower lumbar (L3-L5) osteoporotic vertebral compression fractures between January 2016 and January 2020. Patient characteristics, surgical outcomes, operation time, blood loss, clinical and radiological features, and complications were compared between two groups. Cement leakage, height restoration, and cement distribution were calculated from the radiographs. Visual pain analog scale (VAS) and Oswestry Disability Index (ODI) were calculated before surgery, immediately post-surgery, and 2 years after surgery.
RESULTS: The mean age, sex, body mass index, injury time, segmental distribution, and morphological classification of fractures before surgery did not differ significantly between the groups. The results showed significant improvements in the VAS score, ODI score, and vertebral height restoration in each group (p < 0.05), with no significant differences between the two groups (p > 0.05). The mean operation time and extent of blood loss were lower in the unipedicular group than those in the bipedicular group (p < 0.05). Different types of bone cement leakage were observed in both groups. Leakage rate was higher in the bipedicular group than in the unipedicular group. Patients in the bipedicular group showed greater improvement in bone cement distribution than those in the unipedicular group (p < 0.05).
CONCLUSIONS: The clinical and radiological results of unipedicular percutaneous kyphoplasty for treating osteoporotic vertebral compression fractures in the lower lumbar region were similar to those of bipedicular percutaneous kyphoplasty. However, the unipedicular approach resulted in shorter surgical time, less blood loss, and less bone cement leakage. Thus, the unipedicular approach may be preferable owing to its several advantages.
摘要：
背景：据报道，经皮椎体后凸成形术的单椎弓根和双椎弓根入路均可有效治疗骨质疏松性椎体压缩性骨折（OVCFs）。然而,大多数研究报道了胸腰椎骨折，很少有报道描述下腰椎的治疗。这里,我们比较了单椎弓根和双椎弓根入路经皮椎体后凸成形术治疗骨质疏松性椎体压缩性骨折的临床和影像学结果。
方法：我们回顾性回顾了2016年1月至2020年1月160例接受经皮椎体后凸成形术治疗下腰椎骨质疏松性椎体压缩骨折（L3-L5）患者的记录。患者特征,手术结果,操作时间,失血,临床和放射学特征，比较两组并发症发生情况。水泥渗漏,高度恢复，和水泥分布是根据射线照片计算的。术前计算视觉疼痛模拟评分(VAS)和Oswestry残疾指数(ODI),手术后立即，手术后2年。
结果：平均年龄，性别,身体质量指数,受伤时间,分段分布，两组间手术前骨折的形态学分类无显著差异.结果显示VAS评分有显著改善,ODI得分,各组椎体高度恢复（p<0.05），两组间无显著性差异(p>0.05)。单椎弓根组的平均手术时间和失血程度均低于双椎弓根组（p<0.05）。两组均观察到不同类型的骨水泥渗漏。双椎弓根组的渗漏率高于单椎弓根组。与单椎弓根组相比，双椎弓根组患者的骨水泥分布改善更大（p<0.05）。
结论：单椎弓根椎体后凸成形术治疗下腰椎骨质疏松性椎体压缩性骨折的临床和影像学结果与双椎弓根椎体后凸成形术相似。然而,单椎弓根入路可缩短手术时间，减少失血,和更少的骨水泥渗漏。因此，单证方法由于其几个优点可能是优选的。
方法：我们回顾性回顾了2016年1月至2020年1月160例接受经皮椎体后凸成形术治疗下腰椎骨质疏松性椎体压缩骨折（L3-L5）患者的记录。患者特征,手术结果,操作时间,失血,临床和放射学特征，比较两组并发症发生情况。水泥渗漏,高度恢复，和水泥分布是根据射线照片计算的。术前计算视觉疼痛模拟评分(VAS)和Oswestry残疾指数(ODI),手术后立即，手术后2年。
结果：平均年龄，性别,身体质量指数,受伤时间,分段分布，两组间手术前骨折的形态学分类无显著差异.结果显示VAS评分有显著改善,ODI得分,各组椎体高度恢复（p<0.05），两组间无显著性差异(p>0.05)。单椎弓根组的平均手术时间和失血程度均低于双椎弓根组（p<0.05）。两组均观察到不同类型的骨水泥渗漏。双椎弓根组的渗漏率高于单椎弓根组。与单椎弓根组相比，双椎弓根组患者的骨水泥分布改善更大（p<0.05）。
结论：单椎弓根椎体后凸成形术治疗下腰椎骨质疏松性椎体压缩性骨折的临床和影像学结果与双椎弓根椎体后凸成形术相似。然而,单椎弓根入路可缩短手术时间，减少失血,和更少的骨水泥渗漏。因此，单证方法由于其几个优点可能是优选的。
