Rationale and Objectives
To compare the clinical and radiographic results of bipedicular and unipedicular approaches(UPK
and BPK) in the management of metastatic vertebral lesions
Materials and Methods
Eighty-two patients with 159 metastatic vertebral lesions who underwent UPK(25 cases,
69 lesions) or BPK(57 cases, 90 lesions) were retrospectively evaluated. Clinical
results were assessed mainly depending on the Visual Analogue Scale(VAS) score, Oswestry
Disability Index(ODI) and Quality of Life(QoL). Radiographic outcomes were evaluated
primarily on the basis of bone cement distribution and changes in vertebral body height(VBH).
Major and minor complications were systematically evaluated and compared to assess
the safety of the 2 procedures.
Results
No statistically significant differences were observed in age, sex, types of lesions,
location of lesions, posterior vertebral body and/or pedicle involvement, percentage
of vertebra invasion between the groups(p=0.17-0.83). The radiographic parameter VBH was similarly improved in both groups(p=0.26-0.93). There was a significant improvement in the clinical parameters VAS score,
ODI, and QoL at each follow-up examination compared with the preoperative results(p<0.001). Significant improvement was observed in the VBH at each follow-up point(p<0.05) compared to pre-procedure. UPK was superior to BPK in terms of the operative
duration(p<0.001), cement volume(p=0.004), and surgical complications(p=0.04).
Conclusion
Both UPK and BPK resulted in similar clinical and radiographic outcomes in patients
with metastatic vertebral lesions. The UPK had advantages including a shorter operation
and lower cement volume than the BPK, which may have played an important role in reducing
the incidence of complications. UPK can replace BPK in the treatment of metastatic
vertebral lesions.
Key Words
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Article info
Publication history
Published online: November 30, 2022
Accepted:
November 13,
2022
Received in revised form:
November 11,
2022
Received:
October 24,
2022
Publication stage
In Press Corrected ProofFootnotes
W.W. and X.Z. contributed equally.
Identification
Copyright
© 2022 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.
