ORIGINAL RESEARCH article
Front. Aging
Sec. Musculoskeletal Aging
This article is part of the Research TopicInterdisciplinary Insights Into Musculoskeletal Aging: Mechanisms and InterventionsView all 7 articles
PCKP versus UPKP for Moderate-to-Severe Osteoporotic Vertebral Compression Fractures: A Prospective Randomized Controlled Trial Revealing Synergistic Mechanisms of Optimized Bone Cement Distribution and Anti-Osteoporosis Therapy on Medium-to Long-Term Outcomes
Provisionally accepted
- Zigong First People's Hospital, Zigong, China
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Background: Percutaneous curved kyphoplasty (PCKP) demonstrates early advantages in treating osteoporotic vertebral compression fractures (OVCFs), but its long-term efficacy and patient selection criteria remain controversial.Objective: To prospectively compare the mid-to-long-term outcomes of PCKP versus unilateral percutaneous kyphoplasty (UPKP) for single-level OVCFs and establish a hierarchical decision model based on vertebral compression severity.Methods: 139 patients with single-level OVCFs (January 2021-January 2023) were randomized to PCKP (n=67) or UPKP (n=72) with ≥24-month follow-up. Outcomes included VAS, ODI, cement distribution (Type I-V classification), leakage rate, and refracture incidence.Anti-osteoporosis compliance was analyzed for its impact on efficacy.Results: Both groups showed significant postoperative improvement in VAS and ODI (P<0.05).PCKP achieved superior early pain relief (VAS: 1.99±0.77 vs. 3.47±0.50; ODI: 27.07±1.78 vs. 35.33±3.12 at 2 days, P<0.001), higher cement distribution excellence rate (91.04% vs. 76.39%), and lower leakage rate (10.45% vs. 26.39%). However, outcomes converged from 3 months onward (P>0.05), with no significant differences in refracture (11.94% vs. 15.28%) or anti-osteoporosis compliance (28.36% vs. 33.33%). Subgroup analysis revealed PCKP provided more symmetric cement distribution (P=0.02) and 21% lower leakage risk in moderate-severe OVCFs (Genant 2-3).PCKP enhances early biomechanical stability in moderate-severe OVCFs through optimized cement dispersion, while long-term efficacy relies on standardized anti-osteoporosis therapy. A stepwise decision model ("PCKP for Genant 2-3, UPKP for mild cases") combined with "vertebral augmentation-bone metabolism modulation-behavioral intervention" strategy is recommended.
Keywords: Percutaneous curved vertebral kyphoplasty (PCKP), Unilateral puncture percutaneous kyphoplasty (UPKP), Anti-osteoporosis treatment compliance rate, Medium-to long-term efficacy, Anti-osteoporosis treatment compliance rate;
Received: 24 Jun 2025; Accepted: 30 Jan 2026.
Copyright: © 2026 Yang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: FuGuo Yang
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