Modified unilateral transpedicular percutaneous vertebroplasty for treatment of osteoporotic vertebral compression fractures.

Objective: To comparatively assess the clinical outcome of modified unilateral percutaneous vertebroplasty for the treatment of osteoporotic vertebral compression fractures.

Methods: The clinical outcome and incidence of cement extrusion in a consecutive group of 70 patients at our institution between December 2005 and December 2008 was retrospectively reviewed. Thirty-five patients were randomly distributed to modified percutaneous vertebroplasty (Group A) and 35 to traditional percutaneous vertebroplasty (Group B). A visual analog scale (VAS) was used on the first post-operative day and 1 year later to assess the severity of pain before and after vertebroplasty. The incidence of cement extrusion on CT scan was also compared between the two groups.

Results: The treatment was successful in all seventy patients. The incidence of cement extrusion was 14.29% (5/35 patients) in group A, and 37.12% (13/35 patients) in group B, this difference being statistically significant (P < 0.05). No patients had serious complications. Complete pain relief was achieved in 50 patients, and significant relief in the other 20 (20/70 patients). There was no statistically significant difference between Groups A and B.

Conclusion: Modified percutaneous vertebroplasty enhances the accuracy of cement injection into the center of the vertebral body, increasing the safety of the procedure with no increase in cost. It is a safer and more easily performed technique for treating patients with osteoporotic vertebral compression fractures than traditional percutaneous vertebroplasty.