Comparison of Clinical Efficacy Between Vesselplasty and Percutaneous Vertebroplasty in Genant Grade 3 Osteoporotic Vertebral Compression Fracture.

Abstract

In recent years, a modified percutaneous vertebroplasty (PVP) procedure, known as Vesselplasty, has demonstrated favorable clinical outcomes in the treatment of osteoporotic vertebral compression fractures (OVCFs). However, there have been no reports on the application of Vesselplasty for Genant grade 3 OVCFs. This study aims to evaluate the efficacy and clinical outcomes of Vesselplasty in treating Genant grade 3 OVCFs, thereby providing evidence-based guidance for clinical decision-making. A retrospective study was conducted on 41 patients with Genant grade 3 OVCFs who underwent traditional PVP and 54 patients who underwent Vesselplasty at our hospital between February 2019 and January 2023. Clinical data from both groups were compared, including visual analog scale (VAS) scores, relative fractured vertebral height (RFVH), and local kyphosis angle (LKA) before surgery, as well as related complications. Postoperative VAS scores in both groups were significantly lower than preoperative scores, with no significant difference in VAS scores between the 2 groups after surgery. The Vesselplasty group exhibited a significant increase in RFVH (preoperative: 55.93 ± 9.61, 2 weeks: 82.11 ± 8.32, and 1 year: 81.02 ± 7.43) and a significant decrease in LKA postoperatively (preoperative: 27.17 ± 5.37, 2 weeks: 11.15 ± 4.84, and 1 year: 12.01 ± 5.45), whereas the PVP group showed no significant changes in RFVH (preoperative: 56.01 ± 3.54, 2 weeks: 56.29 ± 9.85, and 1 year: 56.13 ± 9.15) or LKA (preoperative: 26.99 ± 6.65, 2 weeks: 26.52 ± 5.77, and 1 year: 26.63 ± 6.27). Multivariate logistic regression analysis revealed that vertebral height (odds ratio: 3.247; 95% confidence interval: 2.749, 12.531; P = 0.000) and LKA (odds ratio: 2.116; 95% confidence interval: 1.302, 4.785; P = 0.000) had shown significant improvement at 1 year. No cases of neurological injury, spinal canal compression, infection, continuous bleeding, cement allergy, or pulmonary embolism were observed in either group. The incidence of cement leakage was significantly lower in the Vesselplasty group compared to the PVP group (1.85%/14.63%; χ² = 12.214; P = 0.000). Both Vesselplasty and PVP techniques effectively alleviate pain symptoms in patients with Genant grade 3 OVCFs. However, Vesselplasty demonstrates superior efficacy in restoring vertebral height, correcting kyphotic deformity, and reducing the risk of cement leakage.