Unilateral Percutaneous Curved Kyphoplasty versus Bilateral Percutaneous Kyphoplasty: A Comparative Study
Introduction:
Osteoporotic vertebral compression fractures (OVCF) are a severe complication of osteoporosis, leading to significant disability and mortality among elderly patients. Early OVCF often presents as thoracolumbar back pain, which may be initially overlooked. Prolonged bed rest due to pain can accelerate bone loss. Epidemiological studies report a mortality rate approaching 50% within four years among patients with OVCF treated conservatively, emphasizing the condition's severity. Percutaneous kyphoplasty (PKP) is currently preferred for OVCF treatment. However, the choice between unilateral and bilateral surgical approaches remains controversial.
Methodology:
This retrospective study compared clinical outcomes between unilateral percutaneous curved kyphoplasty (PCK) and bilateral PKP for single-level OVCF. Patients (n=89) with OVCF admitted to the hospital between September 2023 and December 2024 were included. Baseline characteristics showed no significant differences between groups. The study period's latest follow-up time was 12 months, with a median of 12 months. Perioperative parameters, including surgical duration, intraoperative blood loss, X-ray fluoroscopy exposure, and bone cement volume, were recorded and compared.
Results:
PCK demonstrated shorter operative duration, reduced blood loss, fewer X-ray fluoroscopy exposures, and lower bone cement volume compared to PKP. Bone cement distribution was similar between groups. Visual analogue scale (VAS) pain scores and Oswestry Disability Index (ODI) scores improved significantly in both groups post-surgery, with no significant differences between groups at any time point.
Discussion:
PCK offers intraoperative advantages over bilateral PKP, including reduced radiation exposure and efficiency. The study's findings suggest that PCK is a viable and efficient surgical option for OVCF treatment, especially in elderly patients. Further studies are needed to confirm its long-term non-inferiority.
Conclusion:
This study indicates that PCK's therapeutic outcomes are comparable to bilateral PKP for OVCF in the elderly. PCK's intraoperative advantages make it a promising surgical alternative, warranting further investigation.
