Enhanced bone cement distribution in percutaneous vertebroplasty using a curved guide wire: a propensity score matching analysis.

Autor: Hu X; Anhui No. 2 Provincial People's Hospital Clinical College of Anhui Medical University, No. 1868 Dangshan Road, Yaohai District, Hefei, Anhui, 230000, China.; The Fifth Clinical Medical College of Anhui Medical University, Hefei, Anhui, 230000, China., Zhang Z; School of Engineering, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK., Yang Y; Department of Spine Surgery, Anhui No. 2 Provincial People's Hospital, No. 1868 Dangshan Road, Yaohai District, Hefei, Anhui, 230000, China.; Graduate Department, Bengbu Medical University, Bengbu, Anhui, 233000, China., Zhang G; Department of Spine Surgery, Anhui No. 2 Provincial People's Hospital, No. 1868 Dangshan Road, Yaohai District, Hefei, Anhui, 230000, China., Cao S; Department of Spine Surgery, Anhui No. 2 Provincial People's Hospital, No. 1868 Dangshan Road, Yaohai District, Hefei, Anhui, 230000, China., Yu B; Department of Spine Surgery, Anhui No. 2 Provincial People's Hospital, No. 1868 Dangshan Road, Yaohai District, Hefei, Anhui, 230000, China., Zhang Y; Anhui No. 2 Provincial People's Hospital Clinical College of Anhui Medical University, No. 1868 Dangshan Road, Yaohai District, Hefei, Anhui, 230000, China. zyb701017@163.com.; The Fifth Clinical Medical College of Anhui Medical University, Hefei, Anhui, 230000, China. zyb701017@163.com.
Jazyk: angličtina
Zdroj: BMC musculoskeletal disorders [BMC Musculoskelet Disord] 2024 Oct 22; Vol. 25 (1), pp. 835. Date of Electronic Publication: 2024 Oct 22.
DOI: 10.1186/s12891-024-07951-8
Abstrakt: Background: Osteoporotic vertebral compression fractures (OVCF) severely affect the quality of life in the aged population. Percutaneous vertebroplasty (PVP) alleviates pain and stabilizes vertebrae, but suboptimal bone cement distribution can cause complications. Hence, this study aimed to clarify whether a new technique for PVP, using a curved guide wire, enhances the distribution of bone cement and improves clinical outcomes in patients with OVCF.
Methods: Patients with single-segment OVCF underwent PVP or curved guide wire percutaneous vertebroplasty (C-PVP). Propensity score matching (PSM) was employed to balanced the baseline characteristics. The primary outcomes were the visual analog scale (VAS) and Oswestry disability index (ODI) scores. The secondary outcomes included assessments of bone cement distribution, bone cement injection volume, radiological parameters, and general clinical results. Additionally, Complications and adverse events were documented.
Results: After PSM analysis, each group comprised 54 patients, which significantly reduced baseline differences. The C-PVP group showed better clinical outcomes compared to the traditional PVP group. One month after surgery, the C-PVP group had significantly lower VAS and ODI scores (p < 0.001). These improvements persisted at six months and the final follow-up. Additionally, bone cement distribution scores were better (p < 0.001), injection volume was higher (p = 0.03), leakage was less frequent (p = 0.02), and adjacent vertebral fractures occurred less frequently (p = 0.04) in the C-PVP group. Radiological parameters and overall clinical outcomes revealed no significant differences between the two groups.
Conclusion: The use of curved guide wire in PVP significantly improves bone cement distribution and injection volume, resulting in better clinical efficacy in patients with OVCF.
(© 2024. The Author(s).)
Databáze: MEDLINE
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