Percutaneous Functional Spinal Unit Cementoplasty versus Posterior Spinal Fixation with Vertebroplasty for Symptomatic Chronic Osteoporotic Vertebral Fractures: A Retrospective Study with a 2-Year Follow up

Purpose: To compare the clinical efficacy of percutaneous functional spinal unit cementoplasty (PFsUP) and posterior spinal fixation combined with vertebroplasty (PsF + VP) for the treatment of symptomatic chronic osteoporotic vertebral fractures (scOVFs). Method: Thirty-one patients with scOVFs were included in this retrospective study and divided into PFsUP (n = 14) and PsF + VP (n = 17) groups. Visual analog scores (Vas) and Oswestry Disability index (ODi) were recorded before and after surgery and at the last follow-up. Besides, the local kyphosis angle (lKa) and sagittal vertical axis (sVa) were measured. The operation duration, number of X-ray exposures, amount of blood loss, bed rest duration, hospitalization duration, and presence of complications were recorded. Result: The Vas, ODi, lKa, and sVa after surgery and at the last follow-up were significantly improved in both groups compared to preoperative measurements. The PFsUP group experienced shorter operation duration (78.2 +/- 13.1 vs. 124.7 +/- 14.7, p < 0.001), less blood loss (31.1 +/- 8.1 vs. 334.7 +/- 70.9, p < 0.001), more X-ray exposures (92.1 +/- 14.3 vs. 29.4 +/- 5.5, p < 0.001), shorter bed rest duration (12.4 +/- 3.8 vs. 43.4 +/- 10.0, p < 0.001), shorter hospitalization (6.6 +/- 2.4 vs. 10.9 +/- 2.7, p < 0.001), lower complication rate (28.5% vs. 64.7%, p < 0.05), and higher cement leakage rate (42.9% vs. 5.8%, p < 0.05) than the PsF + VP group. Conclusion: During the treatment of scOVFs, the combination of PFsUP and PsF + VP can restore spinal stability, improve kyphosis, and relieve pain. PFsUP can reduce blood loss and complications, early mobilization, and shorten the hospital stay, but it is associated with a higher cement leakage rate and more radiation exposure

Automated summary

This study compared the clinical efficacy of PFsUP and PsF + VP for the treatment of scOVFs. Both treatments were found to improve symptoms and spinal stability. PFsUP had advantages in terms of shorter operation time, less blood loss, and shorter hospital stay, but also had higher cement leakage rate and more radiation exposure compared to PsF+VP.