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| Efficacy and High-Risk Factors of Cement Leakage in Unilateral and Bilateral Pedicle Approach PVP for Osteoporotic Fractures of the Upper Thoracic Vertebrae |
| GUO Yifan, CHEN Bo, et al |
| Shangluo Central Hospital, Shaanxi Shangluo 726000, China |
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Abstract Objective: To analyze the therapeutic effect of unilateral and bilateral pedicle approach percutaneous vertebroplasty (PVP) on patients with upper thoracic osteoporotic fractures, and to explore the high-risk factors affecting bone cement leakage.Methods: A retrospective analysis was conducted on 151 patients with osteoporotic fractures of the upper thoracic vertebrae who underwent PVP surgery in our hospital from June 2021 to June 2023. Among them, 80 patients with a unilateral pedicle approach were designated as the unilateral group, and 71 patients with a bilateral pedicle approach were designated as the bilateral group. The surgery time, blood loss, and intraoperative cement leakage rate were compared between the two groups, along with the pain levels 7 days post-operation. Based on the occurrence of intraoperative cement leakage, patients were divided into the leakage group and the non-leakage group. Logistic multivariate analysis was used to identify high-risk factors for cement leakage.Results: Compared with the bilateral group, the unilateral group had shorter surgery time, less blood loss, and a lower rate of intraoperative cement leakage (P<0.05). The pain level in the unilateral group 7 days post-operation was significantly lower than in the bilateral group (P<0.05). Statistically significant differences were observed between the leakage and non-leakage groups in terms of age, cement dispersion type, spinal kyphosis Cobb angle, and endplate/posterior wall integrity (P<0.05). Logistic multivariate analysis revealed that age ≥70 years, dispersive type of cement dispersion, high spinal kyphosis Cobb angle, and incomplete endplate/posterior wall were high-risk factors for intraoperative cement leakage in PVP (P<0.05).Conclusion: The unilateral pedicle approach PVP surgery shows more significant therapeutic effects compared to the bilateral approach. Various factors influence cement leakage during PVP surgery, and clinical practice should include a comprehensive preoperative evaluation of patients' conditions and optimization measures to reduce the incidence of cement leakage.
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2024, Vol. 30 
