Single-level lumbar osteoporotic compression fracture treated with unilateral approach percutaneous vertebroplasty via intervertebral foramen-A retrospective controlled study

Purpose To present a novel surgical strategy for the management of lumbar spine osteoporotic vertical compression fracture (OVCF). Methods 182 patients with lumbar single segment OVCF who underwent PVP surgery between June 2020 and June 2021 were included in this retrospective study. Of them, 104 (as members of the bilateral group) received conventional bilateral puncture, while 78 (as members of the unilateral group) underwent unilateral PVP through the intervertebral foramen. Imaging results, follow-up clinical indicators, and perioperative period parameters were compared between the two groups. Results Both patient groups underwent the treatment effectively, with 39 instances in the bilateral group and 27 cases in the unilateral group reporting bone cement leakage; no serious issues, such as spinal cord or nerve injury, occurred. The unilateral group experienced shorter hospital stays, shorter X-ray exposure times during surgery, and lower overall costs (P < 0.05) than the bilateral group. There were no statistically significant differences between the two groups for any of these measures, which included postoperative ambulation time, hospitalization duration, and bone cement injection volume, distribution, and leakage. Two patient groups were followed for a total of 24–48 months, with an average follow-up of 31.97 ± 7.15 months. In the event that the patient breaks another bone while being monitored, the follow-up will terminate. For both patient groups, there was a significant decrease (P > 0.05) in VAS and ODI scores over time, and a significant increase (P < 0.05) in Japanese Orthopaedic Association (JOA) scores over time; however, there was no statistically significant difference (P > 0.05) in VAS, ODI, and JOA scores between the two groups at the corresponding time intervals. Comparing imaging data from postoperative patients in both groups to preoperative findings, there was a decrease in the local Cobb angle (P < 0.05) and an increase in the height of the anterior border of the injured vertebra (P < 0.05). At the comparable time point, there was no statistically significant difference (P > 0.05) in the anterior vertebral edge height and local Cobb angle between the two groups. The unilateral group's learning curve had a steeper slope. Conclusion While there is a learning curve associated with modified unilateral puncture PVP treatment for lumbar OVCF, it can also optimize surgical procedures and save expenses while achieving inspiring therapeutic outcomes.