Osteoporotik omurga kompresyon kırıklarında tek taraflı ve çift taraflı perkütan vertebroplasti uygulamalarının klinik ve radyolojik sonuçlarının karşılaştırılması

Öz

Amaç: Vertebra kompresyon kırıkları (VKK) , yaşlı popülasyonda ağrı ve fonksiyon kaybının en yaygın nedenlerinden biridir. Perkütan vertebroplasti (PVP), minimal invaziv ve kanıtlanmış bir tedavi yöntemidir; ancak optimal yaklaşımın (tek taraflı ve ya çift taraflı ) olması gerektiği halen tartışmalıdır. Bu çalışmanın amacı, ağrılı osteoporotik VKK’lerde tek taraflı ve çift taraflı PVP uygulamalarının klinik ve radyolojik sonuçlarını karşılaştırmaktır. Gereç ve Yöntemler: 2014–2024 yılları arasında 203 hasta (73 erkek, 130 kadın; ort. yaş 65,3 ± 8,9 yıl) ve toplam 309 vertebra düzeyi retrospektif olarak incelendi. Hastalara tek taraflı (n = 104) veya çift taraflı (n = 99) PVP uygulandı. Klinik değerlendirmede VAS ve Oswestry Disabilite İndeksi (ODI) kullanılırken, radyolojik sonuçlarda anterior vertebra yüksekliği restorasyonu ve segmental Cobb açısı düzelmesi değerlendirildi. Bulgular: Her iki yaklaşım da anlamlı ağrı azalması ve fonksiyonel iyileşme sağladı. Çift taraflı PVP, tek taraflı PVP’ye kıyasla daha düşük postoperatif VAS (1,9 vs 2,1; p = 0,040) ve ODI skorları (%23,1 vs %26,3; p = 0,02) ile sonuçlandı. Radyolojik olarak çift taraflı girişimler, daha yüksek anterior yükseklik restorasyonu (%25,8 vs %19,2; p = 0,001) ve daha fazla Cobb açısı düzelmesi (9,1° vs 6,4°; p = 0,001) sağladı. Sement kaçağı oranları her iki grupta benzerdi ve semptomatik komplikasyon görülmedi. Sonuç: Hem tek taraflı hem de çift taraflı PVP, osteoporotik VKK tedavisinde güvenli ve etkili yöntemlerdir. Çift taraflı PVP daha üstün radyolojik düzelme sağlarken, tek taraflı PVP daha az cerrahi yük nedeniyle avantajlıdır. Tedavi seçimi, hasta anatomisi ve prosedürel hedefler göz önünde bulundurularak bireyselleştirilmelidir.

Anahtar Kelimeler

• Çift taraflı perkütan vertebroplasti
• osteoporotik kompresyon fraktürü
• tek taraflı perkütan vertebroplasti
• vertebroplasti

Clinical and radiological outcome comparison of unilateral vs. bilateral percutaneous vertebroplasty for osteoporotic vertebral compression fractures

Öz

Aim: Vertebral compression fractures are a common cause of pain and disability in the elderly population. Percutaneous vertebroplasty is an established minimally invasive intervention, yet the optimal approach (unilateral or bilateral) remains controversial. This study focused on comparing the clinical and radiological outcomes of unilateral versus bilateral percutaneous vertebroplasty in patients with painful osteoporotic vertebral compression fractures. Material and Methods: A retrospective review was conducted on 203 patients (73 males, 130 females; mean age 65.3 ± 8.9 years) with 309 treated vertebral levels from 2014 to 2024. Patients underwent either unilateral (n = 104) or bilateral (n = 99) PVP. Pain and disability were assessed using the Visual Analog Scale (VAS) and Oswestry Disability Index (ODI), while radiological outcomes included anterior vertebral height restoration and segmental Cobb angle correction. Results: Both approaches provided significant pain relief and functional improvement. Bilateral PVP achieved lower postoperative VAS (1.9 vs 2.1, p = 0.040) and ODI scores (23.1% vs 26.3%, p = 0.020) compared to unilateral PVP. Radiologically, bilateral procedures resulted in superior anterior height restoration (25.8% vs 19.2%, p = 0.001) and greater Cobb angle correction (9.1° vs 6.4°, p = 0.001). Cement leakage rates were similar in both groups (≈4%), with no symptomatic complications. Conclusion: Unilateral and bilateral PVP are both safe and effective for osteoporotic VCFs. Bilateral PVP demonstrated superior radiological correction, whereas unilateral PVP remains advantageous due to reduced operative burden. Treatment decisions should be individualized based on patient anatomy and procedural goals.

Anahtar Kelimeler

• Bilateral percutaneous vertebroplasty
• unilateral percutaneous vertebroplasty
• vertebral compression fracture
• vertebroplasty

Kaynakça

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