Comparative Study of Precise CT-Guided Percutaneous Vertebroplasty versus Traditional Percutaneous Vertebroplasty for Thoracolumbar Compression Fractures
Abstract：Objective: To retrospectively compare the clinical efficacy of percutaneous kyphoplasty (PKP) assisted by precise CT-guided puncture with traditional percutaneous methods in patients with osteoporotic vertebral compression fractures (OVCFs).Methods: A retrospective analysis was conducted on 56 patients who underwent PKP for single-segment OVCFs between January 2017 and June 2021. Patients were divided into two groups based on different methods of intraoperative puncture site localization: Group A (precise CT-guided puncture) and Group B (traditional method). Each group consisted of 28 patients. The number of puncture attempts, fluoroscopy times, and operation duration were compared between the two groups. Clinical efficacy was assessed using Visual Analogue Scale (VAS) scores preoperatively and postoperatively. Incidence of procedure-related complications was also monitored.Results: All 56 patients underwent successful puncture and were followed up for an average of 10 months (range: 8~16 months). In Group A (precise CT-guided), the mean operation time was 34.1±7.5 minutes, fluoroscopy times during surgery wer 9.9±2.5, and cement injection volume per fractured vertebra was 5.7±0.8mL. Preoperative VAS score was 8.2±0.8, which decreased to 1.4±0.6 at 6 months postoperatively. In Group B (traditional method), the mean operation time was 48.8±9.5 minutes, fluoroscopy times were 14.5±3.5, and cement injection volume per fractured vertebra was 5.6±0.6mL. Preoperative VAS score was 8.2±0.7, which decreased to 1.5±0.6 at 6 months postoperatively. There were no statistically significant differences between the two groups in terms of cement injection volume and VAS scores at 6 months postoperatively (P>0.05). However, significant differences were found in the number of puncture attempts, operation time, and fluoroscopy times during surgery (P<0.05). Group A achieved a significantly higher single-puncture success rate of 92.9% (26/28) compared to 53.6% (15/28) in Group B. Complications included cement leakage towards the posterior or lateral aspects of the vertebra in 2 cases in Group A and in 3 cases involving both anterior and lateral aspects in Group B. No neurological or spinal cord injury complications occurred in either group, and there were no wound infections.Conclusion: Precise CT-guided puncture based on preoperative PACS system CT measurements significantly improves the success rate of single-puncture procedures and enhances the accuracy of percutaneous techniques compared to traditional methods. This approach reduces the number of fluoroscopy sessions and operation time, offering a more precise, minimally invasive alternative for treating OVCFs. It is deemed a safe, reliable, and effective technique.
2024, Vol. 30 
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