Unilateral Dual-Plane Puncture Percutaneous Vertebroplasty Reduces Re-Collapse in Osteoporotic Vertebral Compression Fractures by Advancing Cement Delivery.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2025;13(21):28 Orthop Surg. 2025 Apr 2;17(5):1322–1331.What this means for my practice?
A unilateral dual-plane puncture strategy during PVP improves cement distribution (both endplates), halves the 1-year re-collapse rate, and yields better pain and disability scores versus traditional unilateral puncture. Clinically, prioritizing techniques that achieve full superior–inferior endplate contact may improve durability of PVP. Limitations include single-center design, radiograph-based distribution assessment, stringent re-collapse criteria, and 1-year follow-up.
Study Summary
One hundred forty-five patients with single-level osteoporotic vertebral compression fractures (OVCFs) were randomized to unilateral dual-plane puncture percutaneous vertebroplasty (PVP) (n=74) or traditional puncture PVP (n=71). The primary outcome was vertebral re-collapse within 1 year. Secondary outcomes included cement distribution (endplate contact), changes in anterior vertebral height (AVH) and local kyphotic angle (LKA), Visual Analog Scale (VAS) pain, and Oswestry Disability Index (ODI). Outcomes were assessed pre-op; 1 day, 1 month, 3 months; and 1 year post-op (mean follow-up 14.8 months). Overall, the unilateral dual-plane technique achieved more full endplate contact and lowered re-collapse (18.9% vs 42.3%; p<0.01), with better 1-year VAS and ODI. These findings suggest that optimizing cement distribution to contact both endplates is a key mechanism to prevent re-collapse and improve longer-term clinical outcomes.
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