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. 2023 Nov 22;18(1):887.
doi: 10.1186/s13018-023-04368-2.

Optimizing percutaneous vertebroplasty: extra-facet puncture for osteoporotic vertebral compression fractures

Huo-Liang Zheng #  1 , Bo Li #  1 , Qin-Yu Jiang #  2 , Lei-Sheng Jiang  1 , Xin-Feng Zheng  3 , Sheng-Dan Jiang  4
Affiliations

Optimizing percutaneous vertebroplasty: extra-facet puncture for osteoporotic vertebral compression fractures

Huo-Liang Zheng et al. J Orthop Surg Res. .

Abstract

Purpose: To assess the safety and efficacy of the extra-facet puncture technique applied in unilateral percutaneous vertebroplasty (PVP) for treating osteoporotic vertebral compression fractures.

Methods: Demographics (age, gender, body mass index and underlying diseases) were recorded for analyzing. Visual analog scale (VAS) and Oswestry Disability Index (ODI) scores as well as their corresponding minimal clinically important difference (MCID) were used to evaluate clinical outcomes. The segmental kyphotic angle, the vertebral compression ratio and bone cement distribution pattern were evaluated by the plain radiographs. The facet joint violation (FJV) was defined by the postoperative computed tomography scan. Binary logistic regression analysis was performed to investigate relationships between multiple risk factors and residual back pain.

Results: VAS and ODI scores in both traditional puncture group and extra-facet puncture group were significantly decreased after PVP surgery (p < 0.05). However, no significant difference was observed between the two groups according to VAS and ODI scores. The proportion of patients achieving MCID of VAS and ODI scores was higher in extra-facet puncture group as compared to traditional puncture group within a month (p < 0.05). Finally, multivariate logistic regression analysis showed that FJV (odds ratio 16.38, p < 0.001) and unilateral bone cement distribution (OR 5.576, p = 0.020) were significant predictors of residual back pain after PVP surgery.

Conclusions: Extra-facet puncture percutaneous vertebroplasty can decrease the risk of FJV and it also has the advantage of more satisfied bone cement distribution.

Keywords: Bone cement distribution; Extra-facet puncture; Facet joint violation; Percutaneous vertebroplasty; Residual back pain.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
CT transversal view of the trajectory after PVP surgery. A Male, 58 years old, who suffered a T12 vertebral fracture and accepted traditional puncture PVP surgery. B Male, 81 years old, who suffered a L2 vertebral fracture and accepted extra-facet puncture PVP surgery
Fig. 2
Fig. 2
Extra-facet puncture PVP surgery with transverse process fracture. Female, 64 years old, who suffered L4 vertebral compression fracture and accepted extra-facet puncture PVP surgery. The postoperative CT transversal image showed L4 transverse process fracture
Fig. 3
Fig. 3
Comparison of the FJV group and the non-FJV group according to the ODI (A) and VAS (B) scores
Fig. 4
Fig. 4
A schematic representation of the orientation of facet joints from T9 to L5
Fig. 5
Fig. 5
A schematic representation of the measure of FJA
See this image and copyright information in PMC

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