[HTML][HTML] Quantitative comparison of vertebral structural changes after percutaneous vertebroplasty between unilateral extrapedicular approach and bilateral …
Objective To compare unilateral extrapedicular vertebroplasty (UEV) and bilateral
transpedicular vertebroplasty (BTV) by quantitatively calculating the structural changes of
fractured vertebral body after percutaneous vertebroplasty (PVP) using 3-dimensional voxel-
based morphometry (VBM). Methods We calculated bone cement volume (BCV); vertebral
body volume (VBV); leaked intradiscal BCV; and spatial, symmetric, and even bone cement
distribution (BCD) in and out of 222 vertebral bodies treated with 2 different PVPs using VBM …
transpedicular vertebroplasty (BTV) by quantitatively calculating the structural changes of
fractured vertebral body after percutaneous vertebroplasty (PVP) using 3-dimensional voxel-
based morphometry (VBM). Methods We calculated bone cement volume (BCV); vertebral
body volume (VBV); leaked intradiscal BCV; and spatial, symmetric, and even bone cement
distribution (BCD) in and out of 222 vertebral bodies treated with 2 different PVPs using VBM …
Abstract
Objective
To compare unilateral extrapedicular vertebroplasty (UEV) and bilateral transpedicular vertebroplasty (BTV) by quantitatively calculating the structural changes of fractured vertebral body after percutaneous vertebroplasty (PVP) using 3-dimensional voxel-based morphometry (VBM).
Methods
We calculated bone cement volume (BCV); vertebral body volume (VBV); leaked intradiscal BCV; and spatial, symmetric, and even bone cement distribution (BCD) in and out of 222 vertebral bodies treated with 2 different PVPs using VBM and evaluated the incidence of subsequent vertebral compression fracture (SVCF). Statistical analyses were conducted to compare values between the 2 different PVPs.
Results
Relative BCV, which is a potential risk factor for SVCF, was higher in the BTV group based on the data using VBM (0.22±0.03 vs. 0.29±0.03; p< 0.001, t-test); however, the SVCF incidence between the 2 surgeries was not significantly different (UEV, 24.7%; BTV, 31%; p= 0.046, chi-square test). Spatial, even, and symmetric BCD along the 3 axes was not significantly different between UEV and BTV using VBM (x, y, z-axis, p= 0.893, p= 0.590, p= 0.908 respectively, chi-square test).
Conclusion
Contrary to intuitive concerns, UEV can inject a sufficient and more optimal BCV than BTV. Additionally, it can inject bone cement spatially, symmetrically, and evenly well-distributed without an increased rate of intradiscal leakage and SVCF compared with BTV based on VBM. Therefore, UEV could be a superior alternative surgical method with similar clinical effectiveness and safety, considering the above results and the consensus that UEV is less invasive.
ncbi.nlm.nih.gov
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