“Targeted Percutaneous Vertebroplasty” Versus Traditional Percutaneous Vertebroplasty for Osteoporotic Vertebral Compression Fracture

Abstract

Objective. In this randomized, nonblinded, controlled study, the feasibility and precision of “targeted percutaneous vertebroplasty” (“targeted PVP”) for osteoporotic vertebral compression fracture (OVCF) was evaluated. Methods. A total of 42 patients, aged 50 to 87 years, with OVCF were randomly divided into 2 groups: A and B. Group A underwent “targeted PVP,” and group B underwent traditional PVP with the guidance of C-arm fluoroscopy. Fluoroscopy times for skin puncture points (FTSPP), total radiation doses (TRD), total fluoroscopy times (TFT), and operation time were set as the main evaluation indicators. Results. FTSPP (1.52 ± 0.51 in group A vs 6.62 ± 2.58 in group B, U < .001), TRD (6.26 ± 1.51 in group A vs 11.32 ± 4.21 in group B, P < .001), TFT (16.57 ± 2.79 in group A vs 26.05 ± 6.18 in group B, P < .001), and operation time (20.05 ± 3.38 in group A vs 25.43 ±5.11 in group B, U < .001) were statistically different in the 2 groups. The incidence of cement leakage that occurred in group A (1/21, 4.76%) was significantly less than that in group B (9/21, 42.9%, P < 0.05). Conclusions. “Targeted PVP” may achieve (1) less skin positioning fluoroscopy times, less total fluoroscopy times and dose, shorter operation time, which is more precise than traditional PVP; (2) less incidence of cement leakage; and (3) visualization of the fractured vertebra, which is probably more valuable for the treatment of complicated OVCF patients.

Beijing Friendship Hospital Osteoporosis Self-Assessment Tool for Elderly Male (BFH-OSTM) vs Fracture Risk Assessment Tool (FRAX) for identifying painful new osteoporotic vertebral fractures in older Chinese men: a cross-sectional study

“…The main indications for PVP for the surgery include the following: (1) Acute OVCF (Magnetic resonance imaging [MRI] on T1-weighted images showed a low signal. MRI on T2-weighted images and short tau inversion recovery sequences showed high signal; (2) VAS (visual analogue scale) ≥6; (3) The patient refused to receive conservative treatment [ 18 ].…”

Is Kummell’s Disease a Misdiagnosed and/or an Underreported Complication of Osteoporotic Vertebral Compression Fractures? A Pattern of the Condition and Available Treatment Modalities

“…Furthermore, targeted PVP appeared to achieve lower skin positioning fluoroscopy times and lower total fluoroscopy times. It used a lower dose, had a shorter operation time, and was more precise than traditional PVP [4]. Targeted PVP also revealed a lower incidence of cement leakage.…”

“…Current literature states that the incidence of KD is around 7% to 37% in elderly individuals. The population in developed countries is aging and KD is a potential complication in up to one-third of OVCFs, which requires discussing an appropriate therapeutic approach for these patients [1][2][3][4][5][6][7][8][9][10][11][12][13][14]. KD usually affects the lower thoracic or upper lumbar region of the spine and it usually involves only a single vertebra [15].…”

The Comparation of Ultrasound and Fluoroscopy-guided for Determining Puncture Entry Point of Percutaneous Vertebroplasty

“…In recent years, some novel ultrasound naviagation technologies have been used in PVP surgery. Xu, et al [14] have reported a "Targeted Percutaneous Vertebroplasty" that is a 3D model of fractured vertebra based on preoperative CT scanning data is built preoperatively, and with the help of preoperative digital design, bilateral skin entry points, needle trajectory, and needle insertion depth are established. However, preoperative CT scanning is not exactly the same posture as that in the real operative procedure, whose deviation could result in serious errors for puncture complications.…”