A contrastive analysis of two bone cement applicators for percutaneous vertebroplasty in the treatment of OVCF: A retrospective study

BackgroundPercutaneous vertebroplasty (PVP) is the mainstream treatment for osteoporotic vertebral compression fractures (OVCF). In order to provide better clinical efficacy and reduce complications, various bone cement applicators are still being developed and gradually applied in clinical practice. However their clinical results are still to be reported.ObjectiveTo evaluate the clinical efficacy of the novel spiral cement applicators and the traditional push-rod applicators for the PVP treatment of osteoporotic vertebral compression fractures (OVCF).MethodsA retrospective study, from February 2017 to May 2019, was conducted on 107 OVCF patients who received PVP surgeries respectively with spiral applicators (Observation group) and pushrod applicators (Control group). Perioperative indicators, imaging indicators, clinical efficacy, other indicators were collected and compared.ResultsThe follow-up period was two years. The baseline data of the two groups were comparable (<i>P </i>> 0.05). The anterior edge height and kyphosis angle of the injured vertebrae after surgery compared with before surgery increased significantly in both groups (<i>P </i>< 0.05). The midline height in the observation group after surgery compared with before surgery increased significantly (<i>P </i>< 0.05). The kyphosis angle after surgery and these recovery rates of kyphosis angle, the anterior edge height, the midline height, the posterior edge height increased significantly in the observation group compared with the control group (<i>P </i>< 0.05). VAS and ODI in both groups were significantly lower on the 3rd day and 2nd year after surgery than before surgery, and decreased gradually over time (<i>P </i>< 0.05). The VAS and ODI on the 3rd day after surgery were significantly lower in the observation group than in the control group (<i>P </i>< 0.05). The number of fluoroscopy and operation time were significantly lower in the observation group than in the control group (<i>P </i>< 0.05). The rate of bone cement leakage, bone cement diffusion coefficient and cement volume in the observation group were significantly higher than that of the control group (<i>P </i>< 0.05).ConclusionThe spiral applicator is better than the pushrod applicator in reducing the number of fluoroscopy and operation time, restoring vertebral height, correcting kyphosis, alleviating pain immediately, improving function, and facilitating dispersion of cement, with a higher rate of bone cement leakage.