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Background: Osteoporotic vertebral fractures and their complications pose increasing risks to the elderly. The purpose of this study was to evaluate the clinical efficacy of unilateral percutaneous vertebroplasty in patients with osteoporotic vertebral compression fractures (OVCF) by assessing postoperative cement distribution. Objective: This study aimed to investigate the impact of cement distribution on the efficacy of vertebral compression fracture repair to provide effective preventive and therapeutic measures, prevent postoperative vertebral re-fracture, and improve surgical outcomes. Methods: A total of 170 patients who underwent unilateral percutaneous vertebroplasty at our hospital from January 2020 to December 2022 were selected. Based on the postoperative X-ray cement distribution morphology, they were divided into the good distribution group (n = 87) and the poor dispersion group (n = 83). The basic information of patients, surgery-related indicators including operation time, total hospitalization costs, postoperative hospitalization time, cement injection volume, visual analog scale (VAS) for back pain, Oswestry Disability Index (ODI) for back pain, vertebral height restoration rate, local kyphotic angle of the vertebra, and incidence of re-fracture of injured and adjacent vertebrae were compared between the two groups, and the follow-up results of all patients were recorded. Results: There were no significant differences in age, gender, body mass index, fracture days, menopausal age of female patients, bone density T value, medical history, smoking history, alcohol history, and surgical segments between the two groups (P > 0.05). The VAS scores for back pain at 1 month and 1 year postoperatively were significantly lower in the good distribution group than in the poor dispersion group, with statistical significance (P < 0.05). The good distribution group had a significantly lower incidence of re-fracture of injured vertebrae and overall fracture incidence than the poor dispersion group (P < 0.05). There were no statistically significant differences in operation time, cement dosage, cement leakage, postoperative hospitalization time, adjacent vertebral fractures, postoperative vertebral height restoration rate, VAS scores for back pain at preoperative and 1 week postoperative, and ODI at preoperative, 1 week, 1 month, and 1 year postoperative between the two groups (P > 0.05). Conclusion: Compared with the poor dispersion group, patients in the cement distribution group achieved better short-term clinical efficacy, and long-term prognosis effects are still under observation. Moreover, the cement good distribution group significantly reduced the incidence of re-fracture of injured vertebrae and overall fracture incidence, thereby achieving better surgical outcomes. [ABSTRACT FROM AUTHOR]

To evaluate the clinical effectiveness of endoscopic removal of spinal infections and posterior pedicle surgery, including bone grafting, fixation, and chemotherapy, and to outline preventive strategies for complications, offering guidance for clinical practice. Methods: 128 spinal infectious disease patients (2018– 2022) were categorized into Group A (endoscopic removal, n=44) and Group B (posterior pedicle removal+bone grafting+fixation, n=84). Pre-surgery, all received quadruple antibiotic therapy. Metrics tracked: operation time, blood loss, drainage, recovery, stay, transfusion, complications, and pre/post-surgery VAS, ODI, ESR, CRP, PCT, D-dimer, NLR, Hb, albumin. Results: (1) Preoperative data: There were no statistically significant differences in age, gender, body mass index, involved segments, past medical history (cardiovascular and cerebrovascular diseases, respiratory diseases, endocrine system diseases, metabolic diseases and tuberculosis), smoking history, preoperative erythrocyte sedimentation rate, C-reactive protein, procalcitonin, D-dimer, lymphocyte and neutrophil-lymphocyte ratio, hemoglobin, total protein, waist VAS score and waist ODI score (P> 0.05). (2) The main postoperative indexes were significantly lower than those of group B at the last follow-up at 3 months and the last follow-up in group A, and the difference was significant (P< 0.05), the hemoglobin and total protein in group A were significantly higher than those in group B at the last postoperative follow-up (P< 0.05), and the recurrence rate in group B was significantly higher than that in group A, and the difference was significant (P=0.048). (3) Postoperative secondary indicators: the amount of blood transfusion in group A was significantly lower than that in group B, and the difference between the two groups was statistically significant (P< 0.05), while the operation time, intraoperative blood loss and postoperative hospital stay in group A were significantly smaller than those in group B, and the difference between the two groups was statistically significant (P< 0.05). Conclusion: Endoscopic lesion removal for spinal infections achieves similar safety to posterior pedicle surgery, with shorter operation time, less blood loss, lower recurrence, and reduced drainage. It enhances ESR, spine function, and pain relief, meriting promotion. [ABSTRACT FROM AUTHOR]