Therapeutic Efficacy of Percutaneous Vertebroplasty Combined With Gelatin Sponge Filling in Treating Thoracolumbar Fractures: A Retrospective Analysis

Abstract

AIM: Percutaneous vertebroplasty (PVP) effectively treats thoracolumbar fractures (TLF) but is plagued by post-operative bone cement leakage. Placing a gelatin sponge in the spinal canal can enhance bone cement viscosity and reduce its fluidity, potentially lowering leakage risks. This study explores the clinical efficacy of PVP combined with gelatin sponge implantation in treating TLF and assesses its role in reducing bone cement leakage and associated postoperative complications.

METHODS: This retrospective analysis included 120 TLF patients who underwent PVP treatment at the Anji Traditional Chinese Medicine Hospital between January 2022 and September 2024. Based on the use of gelatin sponges during the procedure, patients were divided into a control group, which underwent conventional PVP (n = 67), and an observation group, which received PVP combined with gelatin sponge filling (n = 53). The Visual Analog Scale (VAS) score, Oswestry Disability Index (ODI), anterior edge height and Cobb angle of the injured vertebra, and Beck index were comparatively analyzed between the two groups at three-time points: before the operation, 1 day after surgery, and 3 months postoperatively. Furthermore, the rates of bone cement leakage, adjacent vertebral fractures, adverse reactions, and the Generic Quality of Life Inventory-74 (GQOLI-74) scores were compared between the two groups.

RESULTS: Compared to the preoperative values, the VAS scores and ODI were significantly improved in both groups at 1 day and 3 months after the procedure (p < 0.001). The anterior edge height, Cobb angle, and Beck index were significantly recovered (p < 0.001). However, these indicators showed no significant differences between the two groups before the operation, 1 day and 3 months after the procedure (p > 0.05). Within one year postoperatively, the incidence rates of bone cement leakage and adverse reactions were substantially reduced in the observation group than in the control group (p < 0.05). However, there was no statistically significant difference in the incidence rate of adjacent vertebral fractures between the two groups (p > 0.05). Furthermore, no difference was observed in the scores of each dimension of GQOLI-74 between the two groups before operation (p > 0.05). One year after the operation, the scores of each dimension of GQOLI-74 elevated in both groups (p < 0.001), with higher scores observed in the observation group (p < 0.05).

CONCLUSIONS: Compared to PVP alone, PVP combined with gelatin sponge implantation in treating TLF can effectively reduce the incidence of bone cement leakage and associated postoperative adverse reactions while improving overall quality of life one year after surgery.