Unilateral and Bilateral Percutaneous Vertebroplasty for Thoracolumbar Osteoporotic Vertebral Compression Fracture with Distant Lumbosacral Pain: A Single-Center Retrospective Analysis.

Abstract

Previous studies have found that percutaneous vertebroplasty (PVP) can effectively improve the local pain (LP) of the affected vertebra caused by thoracolumbar osteoporotic vertebral compression fracture (OVCF) regardless of unilateral or bilateral puncture, but there are few reports on whether it is equally effective for the accompanying distant lumbosacral pain. The objective of this study was to analyze the clinical efficacy of unilateral or bilateral PVP in the treatment of thoracolumbar OVCF with distant lumbosacral pain. The clinical data of patients with single-stage OVCF treated with PVP in our hospital from March 2019 to March 2023 were retrospectively analyzed. According to different intraoperative puncture methods, the whole cohort of patients was divided into unilateral puncture group (52 cases) and bilateral puncture group (40 cases). Preoperative, postoperative, and final follow-up were evaluated using a visual analogue scale (VAS) to assess the degree of LP in the fractured vertebrae and distant lumbosacral pain, respectively. The Oswestry Disability Index (ODI) was used to evaluate functional impairment. At the last follow-up, the proportion of patients who achieved the minimum clinical importance difference and acceptable symptom status on these measures was evaluated. The average follow-up time of the 92 patients was 20.1 ± 7.6 months, and the LP, lumbosacral pain VAS score and ODI index at 3 days after surgery, and the last follow-up were significantly improved compared with those before surgery, with statistical differences (P < 0.05), but there was no statistical difference between the above indexes at 3 days after surgery and the last follow-up (P > 0.05). There were no significant differences in LP, lumbosacral pain VAS scores and ODI scores between unilateral puncture group and bilateral puncture group at different time points after surgery (P > 0.05). At the last follow-up, there were no statistically significant differences in the minimum clinical significance of LP, lumbosacral pain VAS score and ODI index and the rate of patients achieving acceptable symptom status between the two groups (P > 0.05). PVP can not only improve the LP and ODI index of the responsible vertebra of OVCF in the thoracolumbar region, but also improve the accompanying distant lumbosacral pain symptoms, and the puncture approach does not affect the improvement of postoperative pain and function.