Key Takeaways & Executive Findings
- •• Percutaneous kyphoplasty resulted in significantly higher bone cement dispersion heights in the anterior and middle vertebral columns and maximum dispersion height compared to percutaneous vertebroplasty. • Both procedures improved clinical outcomes (VAS, ODI, local kyphotic angle) at 6 months, with kyphoplasty showing superior improvements. • Anterior column and maximum bone cement dispersion heights were negatively correlated with Oswestry Disability Index at 6 months, suggesting higher dispersion is associated with better functional outcomes. • Bone cement dispersion height may serve as a potential imaging predictor for evaluating the efficacy of these minimally invasive procedures.
Abstract
BACKGROUND: Studies have shown that patients with osteoporotic vertebral compression fractures exhibit significant individual differences in prognostic outcomes. The underlying mechanisms are closely associated with the choice of surgical technique, the distribution characteristics of bone cement within the vertebral body, and the degree of height restoration of the injured vertebra. OBJECTIVE: To explore the difference in bone cement dispersion height between percutaneous vertebroplasty and percutaneous kyphoplasty in the treatment of osteoporotic vertebral compression fractures. METHODS: A total of 112 patients with single-segment osteoporotic vertebral compression fractures admitted to the Fifth Affiliated Hospital of Xinjiang Medical University from May 2019 to February 2025 were included. According to the surgical method, they were divided into percutaneous vertebroplasty group (n=57) and percutaneous kyphoplasty group (n=55). The visual analog scale score, Oswestry disability index, local kyphotic angle of the injured vertebra, and complication incidence were compared between the two groups at 6 months postoperatively. The bone cement dispersion height in the anterior and middle columns of the vertebral body and the maximum dispersion height were compared between the two groups. Pearson correlation coefficient was used to analyze the correlation between bone cement dispersion height and Oswestry disability index at 6 months postoperatively. RESULTS AND CONCLUSION: (1) At 6 months postoperatively, the visual analog scale score, Oswestry disability index, and local kyphotic angle of the injured vertebra in both groups were lower than those before surgery (P < 0.05). At 6 months postoperatively, the visual analog scale score, Oswestry disability index, and local kyphotic angle in the percutaneous kyphoplasty group were lower than those in the percutaneous vertebroplasty group (P < 0.05). There was no significant difference in bone cement leakage rate and adjacent vertebral fracture incidence between the two groups (P > 0.05). (2) The bone cement dispersion height in the anterior and middle columns of the vertebral body and the maximum dispersion height in the percutaneous kyphoplasty group were higher than those in the percutaneous vertebroplasty group (P < 0.05). (3) Pearson correlation coefficient analysis showed that in the percutaneous vertebroplasty group and percutaneous kyphoplasty group, the bone cement dispersion height in the anterior column and the maximum dispersion height were significantly negatively correlated with the Oswestry disability index at 6 months postoperatively (r=-0.730, P < 0.001; r=-0.700, P < 0.001; r=-0.581, P < 0.001; r=-0.468, P < 0.001). There was no significant correlation between the bone cement dispersion height in the middle column and the Oswestry disability index at 6 months postoperatively in the two groups (r=-0.089, P=0.520; r=-0.024, P=0.859). (4) The results indicate that the three-dimensional dispersion height of bone cement in the vertebral body can serve as a potential imaging predictor for evaluating the efficacy of percutaneous vertebroplasty and percutaneous kyphoplasty.
1. Introduction
With the aging of the population, the incidence of osteoporotic vertebral compression fractures (OVCFs) has increased significantly. Epidemiological data show that the incidence of OVCFs in people aged ≥65 years is 14.3%, with women accounting for over 72% [1-3]. Percutaneous vertebroplasty (PVP) was first applied by Galibert et al. [4] in 1984 for the treatment of vertebral hemangioma. After years of technical iteration, the indications have been expanded to OVCFs [5]. Based on PVP, innovative techniques such as percutaneous kyphoplasty (PKP), woven bag vertebroplasty, and percutaneous curved vertebroplasty have been developed [6-7]. Studies have shown that the prognosis of OVCF patients varies significantly among individuals, and the underlying mechanisms are closely related to the choice of surgical technique, the distribution characteristics of bone cement within the vertebral body, and the degree of height restoration of the injured vertebra [8-10]. Some scholars have proposed classifying bone cement dispersion patterns into mass type, mixed type, and diffuse type, but these classifications have not shown significant differences in postoperative outcomes [11]. Therefore, compared with analyzing bone cement dispersion from a three-dimensional perspective, it is more appropriate to analyze the therapeutic effect of OVCF from the aspects of pathogenesis, biomechanics, and vertebral height restoration [12-13]. This retrospective cohort study aims to investigate the differences in efficacy and bone cement dispersion height between PVP and PKP in the treatment of OVCFs.
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Ma Zaichao, Maimaitiyibubaji·Abudukadier, Yang Zengqiang, Li Biao, Zhang Zheng, Cui Yong (2026). Quantitative analysis of bone cement dispersion height and efficacy comparison in percutaneous vertebroplasty and percutaneous kyphoplasty. Chinese Journal of Tissue Engineering Research. https://doi.org/10.12307/2026.21457
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Frequently Asked Questions
What is the difference between percutaneous vertebroplasty and percutaneous kyphoplasty?
Percutaneous vertebroplasty (PVP) involves injecting bone cement directly into the fractured vertebral body through a needle, while percutaneous kyphoplasty (PKP) uses a balloon to create a cavity before cement injection, aiming to restore vertebral height and correct kyphotic deformity.
How does bone cement dispersion height affect clinical outcomes?
Higher bone cement dispersion height, particularly in the anterior column and maximum dispersion, is associated with better functional outcomes as measured by the Oswestry Disability Index, indicating that better cement distribution may improve pain relief and functional recovery.
Which procedure results in better bone cement dispersion?
In this study, percutaneous kyphoplasty resulted in significantly higher bone cement dispersion heights in the anterior and middle columns and maximum dispersion compared to percutaneous vertebroplasty, suggesting that PKP may provide better cement distribution.
Are there any significant differences in complication rates between PVP and PKP?
The study found no significant differences in bone cement leakage rate and adjacent vertebral fracture incidence between the two procedures, indicating similar safety profiles.
Can bone cement dispersion height be used as a predictor of surgical efficacy?
Yes, the study suggests that bone cement dispersion height can serve as a potential imaging predictor for evaluating the efficacy of PVP and PKP, as it correlates with functional outcomes.
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