Unilateral transpedicular percutaneous vertebroplasty: Initial experience

PURPOSE: To compare the radiographic and clinical outcomes of a unipediculate approach with those of standard bipediculate vertebroplasty. MATERIALS AND METHODS: Retrospective review of percutaneous vertebroplasties yielded 18 vertebrae in 17 patients that were treated with a standard bipediculate approach and 57 vertebrae in 32 patients that were treated with a modified unipediculate approach. Anteroposterior radiographs obtained after the procedure were viewed to calculate the percentage of cement opacification in both vertebral halves, and mean values were compared between uni- and bipediculate approaches by using a two-tailed Student t test. Clinical outcomes, including pain relief and change in pain medication requirements, were compared in the two groups by using the χ² or Fisher exact test. RESULTS: With the unipediculate approach, filling across the midline was achieved in 55 (96%) of 57 injections. Mean opacification of vertebral body halves was 83% ± 19 (SD) and 77% ± 16 for the bipediculate and unipediculate approaches, respectively (P = .19). Among patients with available follow-up data, 16 (94%) of 17 patients who underwent the bipediculate procedure and 28 (88%) of 32 patients who underwent the unipediculate procedure achieved adequate pain relief (P = .65) with mean decreases in pain severity of 7.3 ± 3.1 and 6.6 ± 2.9, respectively. CONCLUSION: Use of a unipediculate approach in percutaneous vertebroplasty allows filling of both vertebral halves from a single puncture site with no statistically significant difference in clinical outcome from that of bipediculate vertebroplasty.