Introduction: Vertebroplasty involves distribution of bone cements on fractured vertebral body via a bilateral transpedicular or single extrapedicular approach. There are several studies comparing the clinical results using conventional and extrapedicular approach or only one itself. However, studies of radiologic outcomes depending on the distribution pattern of bone cements were rarely reported. To comparatively assess the radiological outcomes of percutaneous extrapedicular vertebroplasty by injection pattern of bone cement for the treatment of single level osteoporotic vertebral compression fracture.

Methods: Fourty osteoporotic vertebral compression fractures treated with extrapedicular vertebroplasty were allocated four groups according to distribution types of bone cement; Central (Group A ,n=15), Central to paracentral (Group B, n=8), Paracentral (Group C, n=7), Diffuse (Group D, n=10). All groups had done only single level procedure and no extravasation. Vertebral body height and segmental kyphotic angle were analyzed before procedure, after procedure, and at final follow-up. The radiologic results were analyzed using general linear model and p-value of less than 0.05 was considered statically significant.

Results: In all four groups, postoperative vertebral body height (p=0.001) was improved compared with preoperative radiologic findings and there were no statistically significant differences in postoperative segmental kyphotic angle (p=0.060) and each groups (p=0.228, p=0.179). At 6 months follow-up, vertebral body height was worsen compared with preoperative and postoperative radiologic results and in segmental kyphotic angle and each groups were not statistically significant differences.

Conclusions: According to our radiologic results, in the process of vertebroplasty using extrapedicular approach as the treatment for osteoporotic vertebral compression fracture, the injection pattern of bone cement for augmentation of collapse vertebral body do not affect final the compression ratio and segmental kyphotic angle change of vertebral body.

Patient Care: It will provide informations related to the bone cement injection.

Learning Objectives: Participants should be able to describe the importance of distribution of bone cement.

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