Percutaneous pedicle screw combined with percutaneous kyphoplasty for osteoporotic vertebral compression fractures with endplate depression: A randomized controlled trial

Objective

This study investigated the efficacy of a combined technique involving percutaneous pedicle screw fixation and percutaneous kyphoplasty in treating osteoporotic vertebral compression fractures with endplate depression.

Methods

A prospective cohort of 120 patients with osteoporotic vertebral compression fractures with endplate depression was classified into Group A (n = 58, percutaneous pedicle screw fixation + percutaneous kyphoplasty) and Group B (n = 62, percutaneous kyphoplasty). Radiographic parameters, visual analog scale score, and Oswestry Disability Index were systematically compared between the two groups postoperatively.

Results

Group A demonstrated significantly better Cobb angle correction than Group B (p <  0.05). Both percentage of the anterior and central vertebral height of the injured vertebra were significantly higher in Group A across all time points (p <  0.05). Group A exhibited significantly less secondary loss of Cobb correction angle and percentage of secondary loss of vertebral height (p <  0.05). The Oswestry Disability Index was significantly lower in Group A from postoperative 3 months to 2 years (p <  0.05).

Conclusions

The application of percutaneous pedicle screw fixation + percutaneous kyphoplasty demonstrates significant advantages in treating osteoporotic vertebral compression fractures with endplate depression, including enhanced reduction efficacy, reduced postoperative secondary loss of correction, and decreased risk of implant failure. This approach represents a safe and effective therapeutic strategy.

Trial registration: Chinese Clinical Trial Registry (No. ChiCTR2500104911)