Comparison of three techniques in the surgical management of metastatic vertebral fracture with posterior wall damage: a retrospective study

Journal of Orthopaedic Surgery and Research

Research Article

Guangdong Chen¹  Yijie Liu¹  Jile Xie¹  Heng Wang¹  Weimin Jiang² 

[1] Department of Orthopaedic Surgery, First Affiliated Hospital of Soochow University, 899 Pinghai Road, Suzhou, China;Department of Orthopaedic Surgery, First Affiliated Hospital of Soochow University, 899 Pinghai Road, Suzhou, China;Department of Orthopaedic Surgery, Dushu Lake Hospital Affiliated to Soochow University, 9 Chongwen Road, Suzhou, China;

关键词: Kyphoplasty;    Spinal metastases;    Spine;    Vertebral fracture;    Pedicle screw fixation;   

DOI  :  10.1186/s13018-023-03608-9

 received in 2022-09-05, accepted in 2023-02-12,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundTo retrospectively compare the safety and efficacy of percutaneous kyphoplasty (PKP), internal fixation (IF), and kyphoplasty combined with internal fixation (KP + IF) in treating metastatic vertebral fracture (MVF) with posterior wall damage.Methods87 patients with MVF with posterior wall damage underwent surgery. In Group PKP, 36 patients underwent PKP; in Group IF, 20 patients underwent pedicle screw fixation; and in Group KP + IF, 31 patients underwent kyphoplasty combined with pedicle screw fixation. Operative time, intraoperative blood loss, clinical and radiological results, and complication rate in each group were evaluated and compared.ResultsSignificant improvement on the VAS, ODI scores, vertebral height and local kyphotic angle (LKA) was noted in each group (P < 0.001). Group PKP and Group KP + IF achieved better pain relief than Group IF (P < 0.05). At postoperative 3 days, Group PKP had better pain relief than Group KP + IF (P < 0.05). At other follow-up time points, there were no differences between Group PKP and KP + IF (P > 0.05). Group KP + IF and Group IF were more efficacious than Group PKP in terms of height restoration and LKA correction (P < 0.05). Group KP + IF had a higher incidence of postoperative complications than Group PKP and Group IF(P < 0.05).ConclusionsPKP was safe and effective in treating MVF with posterior wall damage. It can achieve similar clinical outcomes compared to KP + IF, but associated with less operative time, less blood loss and fewer complications. IF alone should not be the first treatment option for its poorer analgesic effect.

【 授权许可】

CC BY   
© The Author(s) 2023

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