Study of Unilateral Extrapedicular and Bilateral Pedicle Approach Percutaneous Kyphoplasty for Osteoporotic Vertebral Compression Fracture.

Objective: To determine the efficacy and complication of unilateral extrapedicular approach (UEA) and bilateral pedicle approach (BPA) percutaneous kyphoplasty (PKP) in treating thoracolumbar osteoporotic compression fractures. Methods: A descriptive study. Methods: Department of Orthopaedics, Bazhou district people Hospital, Sichuan, China, from December 2016 to March 2021. Methods: Patients with single-level thoracolumbar osteoporotic compression fractures, who underwent BPA and UEA PKP, were divided into the UEA (n=47) and BPA group (n=42). Index was recorded including operation duration, bone cement volume, intraoperative X-ray times, complication, visual analogue scale (VAS), Cobb angle, Oswestry dysfunction index (ODI), the recurrence rate of the injured vertebra and adjacent vertebral fractures within 12 months after operation. Results: There were significant differences in operation duration, bone cement volume, and intraoperative X-ray time between the two groups (p<0.05). VAS, Cobb angle, and ODI significantly improved at 3 days and 12 months after the surgery in each group (p<0.05), but no significant statistical difference was found at each time point between the groups (p>0.05). Bone cement leaked 2 cases in UEA and 8 cases in the BPA group (p<0.05). No pulmonary embolism, neurovascular injury, and infection occurred. No significant difference was found in fracture recurrence rate within 12 months after operation (p>0.05). Conclusions: Unilateral extrapedicular percutaneous kyphoplasty is an effective and safe way in treating thoracolumbar osteoporotic fractures with relatively less duration of surgery, intraoperative X-ray exposure, bone cement volume, and leakage rate.

Background: Thoracolumbar osteoporotic compression fractures, Unilateral extrapedicular approach, Percutaneous kyphoplasty, Bilateral pedicle approach.