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Clinical efficacy analysis of single-balloon unilateral trans-midline expansion with modified PKP for OVCF |
ZHENG Yipeng1, GU Tongtong1, LIU Kang1, WANG Qian2, WANG Yanfeng1 |
1. Orthopedics, 2. Radiology Department, Baoding Second Central Hospital, Baoding 072750, China |
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Abstract Objective To investigate the efficacy of single balloon unilateral transmedial dilatation modified percutaneous balloon dilatation vertebral kyphoplasty (PKP) in the treatment of osteoporotic vertebral compression fractures (OVCF). Methods A total of 115 patients with OVCF in our hospital from August 2021 to June 2022 were selected and grouped according to different surgical methods. Among them, 58 patients were treated with unilateral transmidline dilated PKP with single balloon as the study group, and 57 patients were treated with bilateral pedicle PKP as the control group. The surgical conditions, traumatic stress indexes [prostaglandin E2(PGE2), noadrenaline (NE), Substance P (SP) ] before and after surgery, spinal and pelvic sagittal balance parameters [loss rate of injured vertebra height, Cobb Angle, sagittal deviation (SVA), thoracic kyphosis Angle (TK), lumbar lordosis Angle (LL), pelvic incidence Angle (PI), Pelvic inclination Angle (PT), sacral inclination Angle (SS) ], lumbar function (ODI score, JOA score), pain degree (VAS score), bone turnover markers [type Ⅰ collagen cross-linked carboxy-terminal peptide (CTx), β-collagen degradation products (β-CTx), type Ⅰ procollagen amino terminal propeptide (PINP) ], incidence of postoperative adverse events. Results The surgery time and intraoperative fluoroscopy frequency in the study group were less than those in the control group, and the amount of bone cement injection was higher than that in the control group; The serum levels of PGE2, NE, and SP in the study group were lower than those in the control group on the 1st, 3rd, and 7th day after surgery; There was no significant difference in the loss rate of vertebral height, Cobb angle, SVA, TK, LL, PI, PT, SS between the study group and the control group at 3 and 6 months after surgery; There was no significant difference in ODI, JOA, and VAS scores between the study group and the control group at 3 and 6 months after surgery; The incidence of postoperative residual back pain in the study group was lower than that in the control group. Conclusion sBoth single-balloon unilateral transmedial expansion modified PKP and conventional bilateral arch puncture PKP for OVCF can correct the spinal pelvic architecture, restore lumbar function and relieve patient pain, while the former can further optimise the procedure, reduce the number of intraoperative fluoroscopies, reduce tissue damage and lower the risk of residual postoperative back pain, but increase the amount of bone cement used.
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Received: 22 March 2023
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