Abstract:Objective To investigate the safety and efficacy of extrapedicular approach percutaneous vertebroplasty(PVP) in the treatment of osteoporotic thoracic fractures with pedicle dysplasia.Methods We retrospectively analyzed 43 cases had osteoporotic thoracic fractures with pedicle dysplasia from January 2016 to January 2020.There were 16 males and 27 females with an average age of (72.40±5.02)years (range,60~82 years).Pedicle dysplasia was defined as undeveloped cancellous bone marrow cavity,and only cortical bone was connected.Preoperative X-ray and CT examination showed that the pedicle was abnormal.The study included 18 cases of T5,16 cases of T6 and 9 cases of T7.Extrapedicular approach PVP was performed for every patients.Gender,age,bone mineral density,fractured vertebral body,operation time,bone cement injection volume and follow-up time were recorded.Visual analogue scale(VAS) and vertebral height ratio at preoperation,1 day after operation,3 months after operation and the last follow-up were recorded and compared.Oswestry disability index(ODI) at preoperation,3 months after operation and the last follow-up were recorded and compared.Results All 43 patients were followed up for 12~24 months,with an average of (17.16±3.79)months.The operation time was (27.65±4.52)min,and the injection volume of bone cement was (2.19±0.54)mL.The VAS of all patients were (6.56±0.54) before surgery,(2.14±0.35) 1 day after surgery,(1.74±0.49) 3 months after surgery,and (1.09±0.29) at the last follow-up (all P<0.05).The ODI of all patients were (74.07±4.32)% before surgery,(22.95±2.73)% 3 months after surgery,and (18.19±2.37)% at the last follow-up (all P<0.05).The vertebral height ratio of all patients were (88.56±5.48)% before surgery,(88.44±5.50)% 1 day after surgery,(86.91±5.36)% 3 months after surgery,and (86.21±5.00)% at the last follow-up.At the last follow-up,the loss of vertebral height ratio was statistically significant lower than preoperation(P<0.05).Paravertebral bone cement leakage was found in 4 cases,and bone cement leakage in intervertebral disc was found in 1 case.No bone cement leakage in spinal canal and pulmonary embolism.were found.Conclusion Extrapedicular approach PVP is safe and effective in the treatment of osteoporotic thoracic fractures with pedicle dysplasia.
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