Mixed reality–guided vertebroplasty versus traditional fluoroscopy group in the treatment of osteoporotic vertebral compression fracture: A randomized controlled trial

Background: Osteoporotic vertebral compression fractures (OVCFs) are common among the elderly, and percutaneous vertebroplasty (PVP) is the standard minimally invasive procedure for treating OVCF, but previous PVP mainly uses X-ray fluoroscopy, which poses additional radiation and complication risks to patients. Objective: To explore the clinical efficacy of PVP for treating OVCFs with the assistance of mixed reality (MR) navigation technology. Methods: Forty OVCF patients were tested in the prospective, randomized, and controlled study and were randomly grouped into MR-guided group and conventional fluoroscopy group with 20 patients, respectively. The indicators such as surgery duration, number of fluoroscopy, pain scores, and surgical complications between both groups were evaluated. Results: The comparison between the MR-guided group and the control group in terms of surgical duration, number of fluoroscopy, bone cement dosage, and bone cement leakage showed that the MR-guided group (26.00 minutes [26.00–27.75]) had a significantly shorter surgical duration than that of the control group (29.00 minutes [27.25–34.25]) ( p < 0.001). The MR-guided group (26.00 times [25.25–32.75]) had a fewer number of total fluoroscopy than that of the control group (35.00 times [31.00–41.00]) ( p < 0.05), a higher bone cement dosage than that of the control group ( p < 0.05), and the bone cement leakage rate is lower in the MR-guided group (10.00%) compared with the control group (30.00%); however, there was no statistically significant difference ( p > 0.05). Pain relief and vertebral height restoration postoperative and during follow-up were comparable between the 2 groups ( p > 0.05). Conclusions: MR-guided PVP surgery for the treatment of OVCF can significantly reduce surgical duration, the number of punctures, the number of fluoroscopy, radiation exposure to both patients and medical staff, and the risk of surgery-related complications and featured as a safe, precise, and efficient auxiliary technology that merits wider application in minimally invasive spinal surgery.