Can an unipedicular approach replace bipedicular percutaneous vertebroplasty for osteoporotic vertebral compression fracture?

Abstract

OBJECTIVE: To compare outcomes of unipedicular versus bipedicular approach for percutaneous vertebroplasty for the treatment of thoracolumbar acute osteoporotic vertebral compression fracture (AOVCF). METHOD: From November 2014 to September 2015, 382 patients with AOVCF were randomly assigned to the unipedicular and bipedicular groups. Clinical outcomes and complications were compared. RESULTS: Both groups were comparable with respect to bone cement leakage and adjacent vertebral fractures (P> 0.05). Although the bipedicular approach was found to be superior in terms of reduction of kyphosis and loss of reduction, frequency of x-ray fluoroscopy, VAS and ODI scores, the volume of cement injected and operating time, the between-group differences were not statistically significant (P> 0.05). Nerve root stimulation was more frequent in the unipedicular group (P< 0.05). CONCLUSIONS: The clinical and radiological outcomes of both procedures were comparable. The unipedicular approach was associated with more nerve root stimulation.