A Prospective, Randomized and Controlled Study on MR-guided Vertebroplasty for Osteoporotic Vertebral Compression Fracture Therapy

Objective Osteoporotic vertebral compression fractures (OVCFs) are common among elderly individuals. Vertebroplasty is the standard minimally invasive procedure for treating OVCFs, but traditional surgeries rely on X-ray fluoroscopy, which poses radiation exposure and complication risks. The use of mixed reality (MR) navigation technology may increase surgical precision and safety. Methods This prospective randomized controlled trial included 40 OVCF patients, who were randomly divided into an MR navigation group and a traditional fluoroscopy group, with 20 patients in each group. Surgical time, number of fluoroscopies, pain scores, and complication rates were compared between the two groups. Results In the MR navigation group, the surgery time (29.50 min [26, 37.25] vs. 38.00 min [34.25, 45], P  < 0.05) and number of fluoroscopies (20.0 [20.0, 22.0] vs. 29.0 [28.0, 30.0], P  < 0.01) were lower than those in the control group, whereas the amount of bone cement used in the navigation group was significantly greater than that in the traditional group (6.05 ± 1.93 ml vs. 4.50 ± 1.96 ml, P  < 0.05). In terms of the bone cement penetration rate, the navigation group was better than the traditional group (10% vs. 30%), but the difference was not statistically significant (P > 0.05). Postoperative pain relief and vertebral height restoration were comparable between the two groups. Conclusion MR navigation significantly reduces surgery time, radiation exposure, and complication risks in vertebroplasty for OVCFs. It is a safe, precise, and efficient auxiliary technology that merits wider application in minimally invasive spinal surgery.