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<p>Safe and effective minimally invasive treatments are lacking for very severe osteoporotic vertebral compression fractures (vsOVCF), especially in patients with upper and lower endplate fractures or nonunion of old fractures. This study introduces a minimally invasive approach for the treatment of vsOVCF and introduces a new concept called functional spinal unit height (FSUH) to assess biomechanical stability of the spine after surgery. From January 2020 to January 2022, forty patients with vsOVCF who received percutaneous vertebral-intervertebral plasty (PVIP) were retrospectively reviewed. The clinical and radiological assessments were reviewed. One patients had adjacent vertebral fractures(AVF) due to a trauma after the operation (rate of AVF, 2.9%). The mean course of patients was 56.2 ± 40.3 d, bone mineral density (T-Score) was − 3.6±-0.6, mean operation time was 81.8 ± 12.1&#xa0;min, mean blood loss was 42.5 + 12.9 mL, and mean hospital stay was 5.6 ± 2.2 d. The average Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and local kyphosis angle (LKA) scores before operation were 6.9 ± 0.8, (74.0 ± 6.3)%, and (29.0 ± 7.6)°, decreasing to 2.6 ± 1.1, (32.3 ± 3.9)%, and (21.8 ± 4.1)° 1 week after operation, to 2.1 ± 0.8, (28.1 ± 4.0)%, and (19.9 ± 3.7)° 6 months after operation, and further decreased to 1.0 ± 0.7, (24.4 ± 3.9)%, and (20.0 ± 4.1)° at the last follow-up. Differences in LKA, VAS and ODI scores were statistically significant postoperatively.The average FSUH increased from (64.1 ± 7.6) mm before surgery to (75.1 ± 7.8) mm 1 week after surgery, and no significant change in height at 6 months or at the final follow-up was observed, which was still statistically different from that before the surgery. Our results suggest that PVIP is a minimally invasive surgical technique for the treatment of vsOVCF. It can increase FSUH, improve partial kyphotic deformity, maintain spinal biomechanical stability, and reduce the occurrence of AVF.&#xa0;</p>

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Clinical application of percutaneous vertebral-intervertebral plasty in very severe osteoporotic vertebral compression fracture: A new technique

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月30日

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  • Tong-Hao Wang,
  • Guo-Yue Yang,
  • Yin Liu,
  • Li-Qiang Han,
  • Kai-Nan Wu,
  • Yong-Gang Tian,
  • Zhi Liu,
  • Shu-Zhang Guo

摘要

Safe and effective minimally invasive treatments are lacking for very severe osteoporotic vertebral compression fractures (vsOVCF), especially in patients with upper and lower endplate fractures or nonunion of old fractures. This study introduces a minimally invasive approach for the treatment of vsOVCF and introduces a new concept called functional spinal unit height (FSUH) to assess biomechanical stability of the spine after surgery. From January 2020 to January 2022, forty patients with vsOVCF who received percutaneous vertebral-intervertebral plasty (PVIP) were retrospectively reviewed. The clinical and radiological assessments were reviewed. One patients had adjacent vertebral fractures(AVF) due to a trauma after the operation (rate of AVF, 2.9%). The mean course of patients was 56.2 ± 40.3 d, bone mineral density (T-Score) was − 3.6±-0.6, mean operation time was 81.8 ± 12.1 min, mean blood loss was 42.5 + 12.9 mL, and mean hospital stay was 5.6 ± 2.2 d. The average Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and local kyphosis angle (LKA) scores before operation were 6.9 ± 0.8, (74.0 ± 6.3)%, and (29.0 ± 7.6)°, decreasing to 2.6 ± 1.1, (32.3 ± 3.9)%, and (21.8 ± 4.1)° 1 week after operation, to 2.1 ± 0.8, (28.1 ± 4.0)%, and (19.9 ± 3.7)° 6 months after operation, and further decreased to 1.0 ± 0.7, (24.4 ± 3.9)%, and (20.0 ± 4.1)° at the last follow-up. Differences in LKA, VAS and ODI scores were statistically significant postoperatively.The average FSUH increased from (64.1 ± 7.6) mm before surgery to (75.1 ± 7.8) mm 1 week after surgery, and no significant change in height at 6 months or at the final follow-up was observed, which was still statistically different from that before the surgery. Our results suggest that PVIP is a minimally invasive surgical technique for the treatment of vsOVCF. It can increase FSUH, improve partial kyphotic deformity, maintain spinal biomechanical stability, and reduce the occurrence of AVF.