Percutaneous Vertebroplasty for Painful Osteoporotic Vertebral Compression Fractures: A Retrospective Comparative Study of a Negative Pressure‐Guided Technique

OBJECTIVE: To conduct a preliminary evaluation of the feasibility, safety, and radiographic characteristics of a negative pressure-guided percutaneous vertebroplasty (PVP) technique. The primary focus of this study is on the distribution of bone cement and perioperative hemodynamic changes, with the overarching aim of mitigating the common perioperative risks associated with conventional PVP. METHODS: In this retrospective comparative study, patients with vertebral compression fractures underwent either conventional percutaneous vertebroplasty (Normal PVP) or negative pressure-guided percutaneous vertebroplasty (Guided PVP). In the Normal PVP group, bone cement was injected via bilateral pedicles. In the Guided PVP group, cement was injected through a unilateral pedicle while negative pressure suction was applied through the contralateral pedicle. The following parameters were assessed: injected cement volume, perioperative vital signs, anterior vertebral height, local kyphosis angle, visual analogue scale (VAS), Oswestry Disability Index (ODI), and postoperative adverse events. A total of 60 patients were included, with 30 patients in each group. RESULTS: The negative pressure-guided technique was associated with a more homogeneous bone cement distribution, with a distribution index of 1.10 ± 0.12 in the Guided PVP group compared with 0.94 ± 0.18 in the Normal PVP group (p < 0.001). Smaller perioperative fluctuations in mean arterial pressure were observed in the Guided PVP group at 6 s, 3 min, and 5 min after cement injection (p < 0.05). At 3 months postoperatively, anterior vertebral height preservation was greater in the Guided PVP group than in the Normal PVP group (p = 0.017). CONCLUSION: Both groups demonstrated significant pain relief and functional improvement, with no statistically significant differences between groups. Negative pressure-guided PVP appears to be a feasible and safe technique that may promote more favorable bone cement distribution and attenuate perioperative hemodynamic fluctuations. However, given the retrospective design and limited sample size, these findings should be interpreted as exploratory, and further prospective studies are warranted to clarify its clinical advantages.