A novel puncture approach via point “O” for percutaneous kyphoplasty in patients with L4 or L5 osteoporotic vertebral compression fracture

Abstract

[Objective] This study introduced a novel point “O” puncture approach for percutaneous kyphoplasty (PKP) in patients with L4 or L5 osteoporotic vertebral compression fracture (OVCF), and evaluated its clinical and radiographic outcomes.[Methods] Between September 2019 and December 2020, we compared the clinical and radiographic outcomes of 31 cases (36 vertebrae) of “O” entry point PKP intervention (O-PKP), and 31 cases (37 vertebrae) of transverse the process-pedicle approach PKP intervetion (T-PKP).[Results] All participants completed surgery without serious complications. Only 2 T-PKP patients experienced intervertebral disc space leakage. Compared to the T-PKP patients, the O-PKP patients exhibited less operation and fluoroscopy times (P<0.05), comparable blood loss (P>0.05), improved VAS and ODI scores at the final follow-up (P<0.05), more preferable increase in the vertebral compression ratio (P<0.05), comparable Cobb angle (P＞0.05), comparable anteroposterior bone cement distribution, enhanced bilateral bone cement distribution (P < 0.05), and larger sagittal and transverse angles (P<0.05). [Conclusion] Here, O-PKP was indicated for patients with L4 or L5 OVCF. This puncture approach exhibited significant advantages over the T-PKP not only in terms of pain relief, operation time, and fluoroscopy times, but also in the puncture angle, vertebral reconstruction and symmetric cement distribution.