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Peer-reviewedCC BY 4.0Orthopaedic Surgery

Percutaneous Vertebroplasty for Painful Osteoporotic Vertebral Compression Fractures: A Retrospective Comparative Study of a Negative Pressure‐Guided Technique

  • Botao Zhang1,2
  • Zihan Wang3
  • Shibing Zhang1
  • Zhipeng Xi1
  • Xin Chen4
  • Qingyuan Ru1
  • Ke Wu1
  • Rongrong Deng1
  • Xin Liu1
  • Ran Kang1
4 affiliations
  1. 1Department of Spine Surgery Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine Nanjing Jiangsu Province China
  2. 2Suzhou Hospital, Xiyuan Hospital of China Academy of Chinese Medical Sciences (Suzhou TCM Hospital) Suzhou Jiangsu Province China
  3. 3Wuxi Hospital Affiliated to Nanjing University of Chinese Medicine Wuxi Jiangsu Province China
  4. 4Department of Orthopaedics The Second Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing Jiangsu Province China
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Abstract

Objective: To conduct a preliminary evaluation of the feasibility, safety, and radiographic characteristics of a negative pressure‐guided percutaneous vertebroplasty (PVP) technique. The primary focus of this study is on the distribution of bone cement and perioperative hemodynamic changes, with the overarching aim of mitigating the common perioperative risks associated with conventional PVP.

Methods: In this retrospective comparative study, patients with vertebral compression fractures underwent either conventional percutaneous vertebroplasty (Normal PVP) or negative pressure‐guided percutaneous vertebroplasty (Guided PVP). In the Normal PVP group, bone cement was injected via bilateral pedicles. In the Guided PVP group, cement was injected through a unilateral pedicle while negative pressure suction was applied through the contralateral pedicle. The following parameters were assessed: injected cement volume, perioperative vital signs, anterior vertebral height, local kyphosis angle, visual analogue scale (VAS), Oswestry Disability Index (ODI), and postoperative adverse events. A total of 60 patients were included, with 30 patients in each group.

Results: The negative pressure‐guided technique was associated with a more homogeneous bone cement distribution, with a distribution index of 1.10 ± 0.12 in the Guided PVP group compared with 0.94 ± 0.18 in the Normal PVP group (p < 0.001). Smaller perioperative fluctuations in mean arterial pressure were observed in the Guided PVP group at 6 s, 3 min, and 5 min after cement injection (p < 0.05). At 3 months postoperatively, anterior vertebral height preservation was greater in the Guided PVP group than in the Normal PVP group (p = 0.017).

Conclusion: Both groups demonstrated significant pain relief and functional improvement, with no statistically significant differences between groups. Negative pressure‐guided PVP appears to be a feasible and safe technique that may promote more favorable bone cement distribution and attenuate perioperative hemodynamic fluctuations. However, given the retrospective design and limited sample size, these findings should be interpreted as exploratory, and further prospective studies are warranted to clarify its clinical advantages.

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Cite

BibTeXRIS
BibTeX
@article{zhang2026percutaneous,
  title = {{Percutaneous Vertebroplasty for Painful Osteoporotic Vertebral Compression Fractures: A Retrospective Comparative Study of a Negative Pressure‐Guided Technique}},
  author = {Botao Zhang and Zihan Wang and Shibing Zhang and Zhipeng Xi and Xin Chen and Qingyuan Ru and Ke Wu and Rongrong Deng and Xin Liu and Ran Kang},
  journal = {Orthopaedic Surgery},
  year = {2026},
  month = sep,
  doi = {10.1111/os.70432},
  url = {https://doi.org/10.1111/os.70432},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Percutaneous Vertebroplasty for Painful Osteoporotic Vertebral Compression Fractures: A Retrospective Comparative Study of a Negative Pressure‐Guided Technique
AU  - Botao Zhang
AU  - Zihan Wang
AU  - Shibing Zhang
AU  - Zhipeng Xi
AU  - Xin Chen
AU  - Qingyuan Ru
AU  - Ke Wu
AU  - Rongrong Deng
AU  - Xin Liu
AU  - Ran Kang
PY  - 2026
DA  - 2026/09/17
JO  - Orthopaedic Surgery
DO  - 10.1111/os.70432
UR  - https://doi.org/10.1111/os.70432
AB  - Objective: To conduct a preliminary evaluation of the feasibility, safety, and radiographic characteristics of a negative pressure‐guided percutaneous vertebroplasty (PVP) technique. The primary focus of this study is on the distribution of bone cement and perioperative hemodynamic changes, with the overarching aim of mitigating the common perioperative risks associated with conventional PVP.  Methods: In this retrospective comparative study, patients with vertebral compression fractures underwent either conventional percutaneous vertebroplasty (Normal PVP) or negative pressure‐guided percutaneous vertebroplasty (Guided PVP). In the Normal PVP group, bone cement was injected via bilateral pedicles. In the Guided PVP group, cement was injected through a unilateral pedicle while negative pressure suction was applied through the contralateral pedicle. The following parameters were assessed: injected cement volume, perioperative vital signs, anterior vertebral height, local kyphosis angle, visual analogue scale (VAS), Oswestry Disability Index (ODI), and postoperative adverse events. A total of 60 patients were included, with 30 patients in each group.  Results: The negative pressure‐guided technique was associated with a more homogeneous bone cement distribution, with a distribution index of 1.10 ± 0.12 in the Guided PVP group compared with 0.94 ± 0.18 in the Normal PVP group (p < 0.001). Smaller perioperative fluctuations in mean arterial pressure were observed in the Guided PVP group at 6 s, 3 min, and 5 min after cement injection (p < 0.05). At 3 months postoperatively, anterior vertebral height preservation was greater in the Guided PVP group than in the Normal PVP group (p = 0.017).  Conclusion: Both groups demonstrated significant pain relief and functional improvement, with no statistically significant differences between groups. Negative pressure‐guided PVP appears to be a feasible and safe technique that may promote more favorable bone cement distribution and attenuate perioperative hemodynamic fluctuations. However, given the retrospective design and limited sample size, these findings should be interpreted as exploratory, and further prospective studies are warranted to clarify its clinical advantages.
SN  - 1757-7853
SN  - 1757-7861
ER  -