Comparison of percutaneous curved vertebroplasty with bilateral percutaneous kyphoplasty in the treatment of osteoporotic vertebral compression fractures: a focus on surgical parameters, cement infusion, and leakage rate

Osteoporotic vertebral compression fractures (OVCF) are a major health issue, and vertebral augmentation is a common treatment. This study compared percutaneous curved vertebroplasty (PCVP) and bilateral percutaneous kyphoplasty (BPKP) for OVCF. A retrospective cohort study included patients with single-level OVCF treated between January 2019 and January 2024, divided into BPKP and PCVP groups. Surgical parameters, cement infusion metrics, leakage rates, and adjacent fractures were assessed. Clinical outcomes were measured using visual analog scale (VAS) and Oswestry Disability Index (ODI) scores preoperatively, at 24 h, 3 months, and 6 months postoperatively. Vertebral height was evaluated via the Beck index. Of 184 patients (BPKP:96; PCVP:88), PCVP showed significantly shorter operative time (14.82 ± 2.63 min vs 23.45 ± 3.27 min), less blood loss (8.84 ± 2.47 mL vs 12.26 ± 2.21 mL), and lower fluoroscopy use (22.75 ± 2.98 vs 28.03 ± 3.14, all P < 0.001). PCVP used less cement (2.54 ± 0.42 vs. 5.47 ± 0.68 mL, P < 0.001), but achieved better dispersion (effective dispersion multiple: 1.48 ± 0.11 vs. 1.22 ± 0.09, P < 0.001) and distribution (excellent rate: 85.23% vs. 66.67%, P = 0.003). Cement leakage was lower with PCVP (14.77% vs. 31.25%, P = 0.008). At 6 months, PCVP demonstrated statistically lower VAS (13.46 ± 4.14 vs. 15.23 ± 4.89, P = 0.009) and ODI scores (18.79 ± 5.64% vs. 21.36 ± 6.78%, P = 0.006). The Beck index was comparable between groups at all assessed time points. In multivariable logistic regression, PCVP remained an independent protective factor for leakage after adjustment (OR 0.402, 95% CI 0.206–0.784, P = 0.007). In this single-center retrospective cohort, PCVP was associated with shorter operative time, lower fluoroscopy use, lower cement volume, better cement dispersion, and lower cement leakage than BPKP, with comparable vertebral height restoration. PCVP should be regarded as a potentially advantageous alternative to BPKP and prospective randomized trials are needed to confirm these findings.