Efficacy and safety of high-viscosity cement in percutaneous vertebroplasty for treatment of Osteoporotic vertebral compression fractures

Abstract

To evaluate the efficacy and safety of high viscosity bone cement in the percutaneous vertebroplasty (PVP) for treatment of single-level osteoporotic vertebral compression fractures. Eighty patients were enrolled in this study. All patients were received PVP, and they were divided into 2 groups according to the viscosity of bone cement, either high viscosity bone cement (HV group) or low viscosity cement (LV group). Oswestry Disability Index questionnaire and visual analog scale as clinical assessments were quantified. The operative time and injected bone cement volume were recorded. The anterior vertebral height (AVH) and bone cement leakage were evaluated in the radiograph. No significant difference was observed in the operative time. Both groups showed significant improvements in pain relief and functional capacity status (visual analog scale and Oswestry disability index scores) after surgery. Less bone cement volume was injected into the the injured vertebra in the HV group and statistical significance was found between both groups. In the HV group, there was lower leakage rate and less patients of severe leakage compared with the LV group. However, the correction of AVH showed no significant differences between the 2 groups and no significant loss of AVH was observed in 2 groups. High-viscosity and low-viscosity PVP have the similar effects in improving quality of life and relieving pain. There were lower cement leakage rate and less patients of severe leakage in the PVP with high-viscosity bone cement.

Factors and Strategies for Post-Vertebroplasty Residual Pain from Thoracolumbar Osteoporotic Vertebral Compression Fractures (OVCF): a systematic review.

“…Contrary to the former study, three papers reported the different results. F G et al [13]observed the clinical e cacy of high or low viscosity bone cement in 200 OVCF cases the same as Li K et al [15]observed in 80 cases and Miao F et al [16]. observed in 178 cases.…”

“…High-viscosity bone cement can reduce leakage, but whether it has relationship with pain relief rarely reported in the past. In the recent years, 4 four prospective studies [13][14][15][16] and one metaanalysis [17]on viscosity that maybe deal with our question were published. The level evaluation of the ve articles indicated the evidence is relatively high.…”

“…They all drawn the same conclusion that there was no signi cant difference in pain, function, and quality of life with high or low viscosity bone cement. However, the above studies have shown that high-viscosity bone cement is better at preventing bone cement leakage [13,15,16]. There also was a high-quality meta-analysis about the topic in 2017 strengthen the controversy discuss [17].…”

Clinical Comparison of Low and High Injection Volumes of High-viscosity Bone Cement Used in Percutaneous Vertebroplasty

“…In a recently published study involving 130 patients, who underwent percutaneous vertebral augmentation, all patients received 2-to 6-mL cement injections per vertebra during the procedure, and PMMA leakage to the vena cava was found in two cases and to the intervertebral disc was found in eight patients [10]. In another recent study comparing high-viscosity bone cement and low-viscosity bone cement, in which PVP was performed in a total of 80 patients with single-level OVCF, no statistically significant difference was observed in terms of VAS and ODI scores whereas high-viscosity bone cement was reported to cause less PMMA leakage [11]. In the present study, the absence of serious bone cement leakage in both groups may be attributed to the fact that high-viscosity PMMA, which is more effective and safer, has been preferred.…”

A Comparison of Percutaneous Kyphoplasty with High-Viscosity and Low-Viscosity Bone Cement for Treatment of Osteoporotic Vertebral Compression Fractures: A Retrospective Study

“…Scholars tend to divide bone cement into 2 different types, high-viscosity bone cement and low-viscosity bone cement, and then analyze their clinical efficacy and safety. [14][15][16][17] Guo et al 18 pointed out that compared with low-viscosity bone cement, highviscosity bone cement had no difference in clinical efficacy and had a lower cement leakage rate. Ran Lador et al 19 found out that PVP with high viscosity bone cement resulted in less chance of leakage to endplates and vessels.…”