Efficacy of polymethyl methacrylate combined with calcium phosphate cement in percutaneous vertebroplasty for postmenopausal women with osteoporotic thoracolumbar compression fractures.

STUDY

designRetrospective cohort study.

objectiveTo evaluate the safety and efficacy of polymethyl methacrylate bone cement combined with calcium phosphate bone cement in percutaneous vertebroplasty for postmenopausal women, compared with polymethyl methacrylate bone cement alone.

methodsWe analyzed the clinical data of 114 postmenopausal female patients who underwent single-level thoracolumbar PVP surgery at the Orthopedics Department of Baiyun Hospital, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, from January 2023 to June 2024.A total of 55 patients were included in the conventional group and 59 patients were assigned to the combined group, based on the type of filler used during the procedure.Comparative assessments included general demographic characteristics, low back pain Visual Analog Scale (VAS) scores, Oswestry Disability Index (ODI) scores, perioperative parameters (e.g., operative duration, intraoperative blood loss, time to ambulation), imaging findings, postoperative complications, and adverse events.

resultsAll patients successfully underwent the procedure and were followed up for at least one year. No significant differences were observed in baseline data between the two groups.At postoperative follow-up, both groups showed significantly lower low-back pain Visual Analog Scale (VAS) scores and Oswestry Disability Index (ODI) scores compared with preoperative values (P < 0.05). At 1 day and 1 month after surgery, the combined group had significantly lower VAS and ODI scores than the conventional group (P < 0.05). However, by 1 year postoperatively, there were no significant differences in VAS or ODI scores between the two groups (P > 0.05).Compared with preoperative measurements, both groups exhibited significant improvement in lumbar lordosis angle, sagittal Cobb angle, thoracic kyphosis angle, thoracolumbar kyphosis angle, coronal Cobb angle, and vertebral body height at postoperative follow-up (P < 0.05).Furthermore, compared with the conventional group, the combined group demonstrated a lower incidence of cement leakage and adjacent vertebral refracture after PVP, as well as less residual postoperative back pain.

conclusionsIn percutaneous vertebroplasty (PVP) for thoracolumbar vertebral compression fractures in postmenopausal women, the application of methyl methacrylate (PMMA) combined with calcium phosphate cement (CPC) is safe and effective. It significantly alleviates pain, improves surgical outcomes, and enhances patient satisfaction. The efficacy and safety of this combined approach are comparable to PMMA cement alone, with advantages in reducing back pain, improving quality of life, lowering the risk of cement leakage, and decreasing the incidence of adjacent vertebral fractures.