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The Effect of Intraoperative Vertebral Anesthesia on Osteoporotic Fractures Treated With Percutaneous Kyphoplasty

A Prospective Cohort Study

Mao, Genwen PhD*,†; Alemayehu, Dereje G. MD; Yang, Yimin PhD; Wen, Tao BSc; Ou, Yiyan BSc§; Cheng, Yifan BSc§; Ren, Zhiwei PhD*,†

doi: 10.1097/BSD.0000000000000823

Study Design: A prospective randomized cohort study.

Objective: The objective of this study was to investigate the effect of intraoperative vertebral anesthesia on osteoporotic vertebral compression fractures (OVCFs) when treated with percutaneous kyphoplasty (PKP).

Summary of Background Data: Only a few studies have evaluated the intraoperative pain reducing strategies during PKP.

Materials and Methods: A total of 64 patients with OVCFs were enrolled in the study. All of the patients were randomized into 2 groups: the traditional local anesthesia group (from the skin to the periosteum, group A) and the experimental group (from the skin to a vertebral body, group B). Visual Analogue Scale (VAS) score was used to evaluate the degree of pain at six time points, that is, VAS before surgery, VAS during balloon dilation, VAS during bone cement injection, VAS soon after surgery, and VAS 12 hours and 24 hours after surgery. In addition, we noted the patients’ willingness to undergo reoperation if necessary, and the variations in surgical complications between the 2 groups.

Results: There was no significant difference in VAS score before surgery between the 2 groups (t=1.694, P=0.095). The VAS scores during balloon dilatation, bone cement injection and soon after surgery were significantly different between the 2 groups (t=4.405, P=0.000; t=2.481, P=0.016; t=2.992, P=0.004, respectively). The willingness to undergo reoperation was significantly different between 2 groups (χ2=6.020, P=0.049), whereas the complications showed no significant difference (χ2=0.000, P=0.754).

Conclusions: Traditional local anesthesia combined with vertebral anesthesia was effective in alleviating perioperative pain during PKP. No serious complication was noted during the operation.

Level of Evidence: Level I.

*Department of Orthopedics, State Key Clinical Department of China

The Spine Surgery Center

Department of Orthopedics, The First Affiliated Hospital of Xi’an Jiaotong University

§The Medical College of Xi’an Jiaotong University, Xi’an, China

Funded by the Natural Science Foundation of Shaanxi Province (No. 2014JQ2-8054).

The authors declare no conflict of interest.

Reprints: Zhiwei Ren, PhD, Department of Orthopedics, The First Affiliated Hospital of Xi’an Jiaotong University, No. 277 of West Yanta Road, Xi’an 710061, China (e-mail:

Received September 30, 2018

Accepted February 5, 2019

© 2019 by Lippincott Williams & Wilkins, Inc.