Unilateral versus bilateral vertebroplasty for severe osteoporotic vertebral compression fractures.

ABSTRACT

STUDY DESIGN: This was a prospective study of patients who underwent vertebroplasty (VP) at a single institute. OBJECTIVE: The aim of this study was to assess and compare the clinical outcomes and complications of unilateral and bilateral VP in treating severe vertebral compression fractures. SUMMARY OF BACKGROUND DATA Typically, VP involves cement injection by bilateral transpedicular or extrapedicular approach. Recently, several articles reported that unilateral VP can achieve comparable outcomes in most cases. However, few prospective randomized studies compared the clinical outcomes and complications in treating severe vertebral compression fractures. METHODS: Thirty-nine patients with 44 severe osteoporotic vertebral compression fractures (OVCFs) were randomly allocated into 2 groups adopting unilateral or bilateral VP. Preoperative and postoperative pain scores, back disability, and cement leakage were recorded and compared. RESULTS: Significant improvement on the visual analog scale and Oswestry disability index scores were noted in each group, and there were no significant differences between the 2 groups. Cement leakage was seen more in bilateral VP. CONCLUSIONS: Severe OVCFs should be candidates for VP. The unilateral VP can get the same clinical results with fewer complications compared with the bilateral VP.