| Objective: To compare the clinical efficacy of bilateral and unilateral percutaneous vertebroplasty (PVP) in the treatment of osteoporotic vertebral compression fracture (OVCF), and to analyze the risk factors of bone cement leakage. Methods: The clinical data of 205 patients with OVCF who were treated in our hospital from May 2019 to December 2020 were retrospectively analyzed. According to different approaches, they were divided into unilateral group and bilateral group, with 104 cases and 101 cases respectively. The perioperative indexes, visual analogue scale (VAS), Oswestry dysfunction index (ODI), Cobb''s angle and anterior vertebral height were compared between the two groups. The incidence of bone cement leakage and other complications were recorded. The influencing factors of bone cement leakage were analyzed by univariate and multivariate Logistic regression. Results: Compared with the bilateral group, the operation time, the bone cement injection volume and the number of intraoperative fluoroscopy in the unilateral group were shorter (P<0.05). The VAS and ODI scores of the two groups decreased before operation, 3 months after operation and at the last follow-up (P<0.05). Compared with that before operation, the height of the anterior edge of the vertebral body in the two groups increased at 3 months after operation and at the last follow-up, and the Cobb''s angle decreased (P<0.05). There was no significant difference in the incidence of complications between the two groups (P>0.05). Bone cement leakage in patients with PVP was related to bone cement viscosity, cortical fracture, fracture severity, fracture location, age, CT value and bone cement injection volume (P<0.05). The main risk factors of bone cement leakage were bone cement injection > 6ml, severe fracture severity, CT value > 63HU, low bone cement viscosity and cortical fracture (P<0.05). Conclusion: Unilateral PVP is equivalent to bilateral PVP in the treatment of OVCF. Unilateral PVP can reduce the bone cement injection volume, shorten the operation time, reduce postoperative pain and promote the recovery of postoperative function. The most common complication of PVP is bone cement leakage, which is affected by fracture severity, cortical fracture, bone cement viscosity and other factors. |
