Objectives: Vertebroplasty via extrapedicular approach is used in privileged patients in osteoporotic vertebral fractures. Many experimental studies but few clinical studies were conducted. This study aimed to compare extrapedicular percutaneous vertebroplasty to a transpedicular approach radiologically.
Material and Methods: Seventy-nine vertebrae of 53 patients who were treated by extrapedicular and transpedicular vertebroplasty were included in the study. The anterior, middle, and posterior heights of the compressed vertebrae were measured by a technique described by Genant et al. preoperatively and postoperatively by two independent researchers on lateral plain radiographs of the patients. Both the systemic and local complications related to the procedures were enrolled.
Results: Thirty vertebrae were thoracal, and 49 vertebrae were lumbar. The mean follow-up was 14.2±3.6 Months. Thirteen thoracal vertebrae and 14 lumbar vertebrae were operated on via extrapedicular approach, and 17 thoracal, and 35 lumbar vertebrae via transpedicular approach. The mean height of the vertebrae's anterior, middle, and posterior heights was 17.8±6.9 mm, 15.7±6.5 mm, and 25.4±5.2 mm. There was a statistically significant increase in the height of all three columns in both approaches. There were no differences in terms of adjacent and distant fractures. Twenty-three patients had cement leakage into extraosseous tissues. Thirteen patients to the paravertebral soft tissues, seven patients to the intervertebral disc space, and three to the paravertebral vessels.
Conclusion: Extrapedicular percutaneous vertebroplasty is a reliable and effective method similar to transpedicular route in terms of regaining all vertebral column height regain and complications.