Performance of Double-Arm Digital Subtraction Angiography (DSA)-Guided and C-Arm-Guided Percutaneous Kyphoplasty (PKP) to Treat Senile Osteoporotic Vertebral Compression Fractures

Abstract

Background Osteoporotic vertebral compression fracture (OVCF) is a common fracture in the elderly. Conservative treatment requires prolonged bedding, which may lead to serious complications. To explore optimized use of percutaneous kyphoplasty (PKP) in the treatment of senile osteoporotic thoracolumbar vertebral compression fractures, in this study, we used C-arm-guided and double-arm digital subtraction angiography (DSA)-guided PKP to treat OVCF in elderly patients and analyzed the effective recovery. Material/Methods In all, 60 patients who presented with osteoporotic vertebral compression fractures at our hospital between July 2017 and February 2019 were analyzed. They were randomly divided into C-arm-guided group and the double-arm DSA-guided groups. Both groups were treated with percutaneous kyphoplasty. Results A pain VAS score analysis revealed that there was no significant difference between the two groups before surgery (P>0.05). After surgery, the VAS scores showed a significant difference between the C-arm-guided group and the double-arm DSA-guided PKP treatment group (P<0.01). Moreover, with respect to the bone cement dosage, vertebral correction height, operation time, cumulative radiation dose, percolation rate, and volume of bone cement, the double-arm DSA-guided PKP treatment showed significantly better results than the C-arm-guided PKP treatment (P<0.01). Conclusions Our data revealed that double-arm DSA-guided PKP was more accurate in treatment of senile osteoporotic thoracolumbar vertebral compression fractures, producing excellent performance with more accurate intraoperative evaluation, shorter operative time, lower incidence of bone cement leakage, less intraoperative radiation dose, and higher safety, and thus, could be extensively applied to clinical surgery.

Digital Subtraction Angiography-Guided Percutaneous Kyphoplasty in Treatment of Multi-Segmental Osteoporotic Vertebral Compression Fracture: A retrospective single-Center study

“… 17 When designing the puncture path before the operation, the puncture angle can be appropriately increased, and the puncture needle can be guided to penetrate the vertebral body one time by DSA three-dimensional scanning during operation so that the end of the working channel is as close as possible to the middle line of the vertebral body. 18 The results demonstrated that the puncture angle of the DSA-guided group was significantly larger than that of the traditional fluoroscopy group, which may be one of the reasons for the more uniform distribution of bone cement in DSA guided group. Related studies have demonstrated that DSA-guided surgery can reduce intraoperative fluoroscopy times and radiation injury.…”

“…Related studies have demonstrated that DSA-guided surgery can reduce intraoperative fluoroscopy times and radiation injury. 12 , 18 Furthermore, a recent study demonstrated that PKP guided by DSA could reduce the times and doses of fluoroscopy. 19 However, there is no report on the fluoroscopy dose of PKP guided by DSA in treating multi-vertebral osteoporotic fractures.…”