Unipedicular vertebroplasty is a better approach for treating osteoporotic vertebral compression fractures (OVCF) than Bipedicular vertebroplasty.

Zhang L et al.
BMC Musculoskeletal Disorders, 2015
Take Home Pearl:
Unipedicular and bipedicular PVP are safe and effective treatments for OVCF but when compared to bipedicular PVP, unipedicular PVP entails a shorter surgical time and lower X-ray irradiation.

Background:
Osteoporosis is one of the most common systemic disorders that is characterized by alter bone micro- architecture, low bone mass and increased risk of fragility fracture. The prevalence of osteoporosis is expected to increase by 25 % in 2025. The fragility fractures associated with osteoporosis are mostly the vertebral compression fractures (OVCFs). It affects 25% of the postmenopausal women. It also causes substantial pain and deformity resulting in disability and poor quality of life. The OVCF usually includes treatments such as analgesics, external braces and physical therapies. Many techniques of the vertebral body augmentation is now available in order to treat refractory cases. The percutaneous vertebroplasty (PVP) has gained much attention in past few decades for treating OVCF. The PVP provides a rapid pain relief to the patients that last for longer period especially in large case series and nonrandomized controlled trials. PVP are relatively safe and effective but are associated with complications that includes cement leakage, soft tissue damage, pedicle fracture, nerve injury and spinal epidural hematoma. Most leakages are asymptomatic and have severe complications of nerve root or spinal cord compression and pulmonary embolism. Using vertebral venography, gel foam embolization and kyphoplasty, the cement leakage was tried to overcome in the past but it resulted in inconclusive outcomes. High viscosity cements have been demonstrated to