Percutaneous Curved Kyphoplasty in the Treatment of Thoracolumbar Osteoporotic Vertebral Compression Fractures: A Randomized Controlled Trial

Background: To evaluate the clinical efficacy of percutaneous curved kyphoplasty (PCKP) in treating thoracic and lumbar osteoporotic vertebral compression fractures (OVCFs). Methods: Seventy-two patients with single-level thoracolumbar OVCFs were recruited and randomly divided into two treatment groups: percutaneous curved kyphoplasty (PCKP), bilateral percutaneous kyphoplasty (PKP). Bone cement dispersion in the fractured vertebrae was observed. Surgery duration, X-ray frequency, bone cement injection volume, bone cement leakage rate, oswestry disability index questionnaire (ODI)，visual analogue scale (VAS) scores，Cobb angle, and vertebral height were recorded. Results: Both groups of patients at postoperative 24h and 6 months in postoperative VAS score and ODI were compared with preoperative significant improvement, but no statistical difference between two groups; The operative time, intraoperative fluoroscopy times, intraoperative bone cement injection amount and intraoperative bone cement leakage in the PCKP group were significantly less than those in the traditional PKP group, and the differences were statistically significant. The anterior edge height and Cobb angle of the injured vertebra were significantly improved after operation in both groups, but the differences between the two groups were not statistically significant. Conclusion: PCKP has the same short-term effect as traditional bilateral PKP in the treatment of elderly osteoporotic compression fractures, both of which can significantly relieve pain and improve life function. However, PCKP is associated with reduced trauma, less complicated surgery with shorter duration, fewer X-rays, lower complication rate, and quicker postoperative recovery versus traditional bilateral PKP. Trial registration: ChiCTR, ChiCTR2100042859. Registered 25 January 2021- Retrospectively registered, http://www.chictr.org.cn/ ChiCTR2100042859