A retrospective study on the efficacy and safety of bone cement in the treatment of endplate fractures

Zhijian Zhao; Lei Deng; Xi Hua; Haojun Liu; Hao Zhang; Xuejun Jia; Rushuai Wei; Mingming Liu; Nanning Lv

doi:10.3389/fsurg.2022.999406

A retrospective study on the efficacy and safety of bone cement in the treatment of endplate fractures

Front Surg. 2022 Oct 6:9:999406. doi: 10.3389/fsurg.2022.999406. eCollection 2022.

Authors

Zhijian Zhao¹, Lei Deng¹, Xi Hua¹, Haojun Liu², Hao Zhang², Xuejun Jia², Rushuai Wei², Mingming Liu², Nanning Lv²

Affiliations

¹ Department of Orthopaedics, The First Affiliated Hospital of Soochow University, Soochow University, Suzhou, China.
² Department of Orthopedic Surgery, The Second People's Hospital of Lianyungang, Lianyungang, China.

Abstract

Background: Endplate fractures is an important factor affecting the curative effect of percutaneous kyphoplasty for spinal fracture. The purpose of this study is to investigate the effect of sealing endplate fracture with bone cement on minimally invasive treatment of spinal fracture.

Methods: A total of 98 patients with osteoporotic vertebral fractures combined with endplate fractures treated with bone cement surgery in our hospital were retrospectively analyzed. They were grouped according to whether bone cement was involved in the endplate fractures. Group A: bone cement was not only distributed in the fractured vertebral body, but also dispersed into the endplate fractures. Group B: bone cement was confined to the fractured vertebra but did not diffuse into the cracks of the endplate. The basic information, imaging changes of the fractured vertebral body, VAS score, ODI score, bone cement distribution and postoperative complications of the two groups were analyzed and compared.

Results: The height of the injured vertebra and the kyphotic Cobb angle in the two groups were significantly improved after surgery, but the anterior height of the vertebra in group B was lower than that in group A and the kyphotic Cobb angle was higher than that in group A at the last follow-up (P < 0.05). VAS score and ODI score in 2 groups were significantly improved after operation (P < 0.05), but the VAS score and ODI score in group A were lower than those in group B at the last follow-up (P < 0.05). The incidence of bone cement leakage and adjacent vertebral fracture in group A was higher than that in group B (P < 0.05).

Conclusion: Diffusion of bone cement into the cracks of the endplate may also restore and maintain the height of the injured vertebra, relieve pain and restore lumbar function. However, diffusion of bone cement into the cracks of the endplate can increase the incidence of cement leakage and adjacent vertebral fractures.

Keywords: bone cement; endplate; fracture; osteoporosis; percutaneous kyphoplasty.