• Kaiyu Wang, Hao Chen, Fei Feng, and Shuangjiang Zhang.
• Department of Orthopaedics, Beijing Friendship Hospital, Capital Medical University, 95 Yong'an Road, Xicheng, Beijing, 100050, P.R. China.
• World Neurosurg. 2025 Feb 6: 123751123751.

BackgroundIn recent years, a modified percutaneous vertebroplasty procedure, known as Vesselplasty, has demonstrated favorable clinical outcomes in the treatment of osteoporotic vertebral compression fractures (OVCFs). However, there have been no reports on the application of Vesselplasty for Genant grade 3 OVCFs. This study aims to evaluate the efficacy and clinical outcomes of Vesselplasty in treating Genant grade 3 OVCFs, thereby providing evidence-based guidance for clinical decision-making.Patients And MethodsA retrospective study was conducted on 41 patients with Genant grade 3 OVCFs who underwent traditional percutaneous vertebroplasty (PVP) and 54 patients who underwent Vesselplasty at our hospital between February 2019 and January 2023. Clinical data from both groups were compared, including visual analog scale (VAS) scores, relative anterior vertebral height (RFVH), and local kyphosis angle (LKA) before surgery, as well as related complications.ResultsPostoperative VAS scores in both groups were significantly lower than preoperative scores, with no significant difference in VAS scores between the two groups after surgery. The Vesselplasty group exhibited a significant increase in RFVH (Preoperative: 55.93±9.61, 2 weeks: 82.11±8.32, 1 year: 81.02±7.43) and a significant decrease in LKA postoperatively (Preoperative: 27.17±5.37, 2 weeks: 11.15±4.84, 1 year: 12.01±5.45), whereas the PVP group showed no significant changes in RFVH(Preoperative: 56.01±3.54, 2 weeks: 56.29±9.85, 1 year: 56.13±9.15) or LKA(Preoperative: 26.99±6.65, 2 weeks: 26.52±5.77, 1 year: 26.63±6.27). Multivariate logistic regression analysis revealed that vertebral height (OR: 3.247, 95%CI: [2.749, 12.531], P = 0.000), LKA (OR: 2.116, 95% CI: [1.302, 4.785], P = 0.000), had shown significant improvement at 1 year. No cases of neurological injury, spinal canal compression, infection, continuous bleeding, cement allergy, or pulmonary embolism were observed in either group. The incidence of cement leakage was significantly lower in the Vesselplasty group compared to the PVP group (1.85%/14.63%, χ2=12.214, P=0.000).ConclusionBoth Vesselplasty and PVP techniques effectively alleviate pain symptoms in patients with Genant grade 3 OVCFs. However, Vesselplasty demonstrates superior efficacy in restoring vertebral height, correcting kyphotic deformity, and reducing the risk of cement leakage.Copyright © 2025. Published by Elsevier Inc.

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