Kambin triangle approach in percutaneous vertebroplasty for the treatment of osteoporotic vertebral compression fractures

The aim of this study was to evaluate the safety and efficacy of percutaneous vertebroplasty (PVP) in Kambin triangle approach for the treatment of osteoporotic vertebral compression fractures (OVCFs). Between November 2017 and September 2018, 109 patients (144 vertebral bodies) with OVCFs, with a mean age of 76.7 ± 9.9 years (55–96 years), underwent PVP in Kambin triangle approach. The time of operation, the volume of bone cement, the incidence of complication, the Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) score, the position of puncture needles, and the spread of polymethylmethacrylate (PMMA) in vertebral body (VB) were recorded. All patients had been completed the operation successfully and were followed up 9.1 ± 2.9 months. The average operation time of each VB was 24.0 ± 3.5 minutes. The average volume of cement was 4.8 ± 0.6 ml. The mean VAS scores were 8.4 ± 0.7 preoperatively, 1.6 ± 0.6 at the first day postoperatively, and 1.2 ± 0.6 at the last follow-up. The mean ODI scores were 70.97 ± 7.73 preoperatively, 27.99 ± 4.12 at the first day postoperatively, and 19.65 ± 3.49 at the last follow-up. The position of puncture needles in the VB was: 119 vertebral puncture needles reached the midline, 15 were close to the midline, and 10 exceeded the midline. The spread of PMMA in the VB was: type 1 in 81 levels (56.3%), type 2 in 37 (25.7%), type 3 in 18 (12.5%), type 5 in 8 (5.5%), and no case in type 4. One case developed pneumothorax after operation. No other complications (hematoma, cement embolism, spinal cord, and nerve injury) occurred. Kambin triangle approach in PVP, which can deliver the puncture needle to the midline of VB easily and with excellent cement distribution, is a safe and effective method.