Abstract: Objective To study the effects of the lateral decubitus position on the bone cement distribution in the elderly patients with osteoporotic vertebral compression fracture (OVCF) undergoing unilateral percutaneous kyphoplasty (PKP). Methods A retrospective analysis was conducted in the patients who underwent unilateral PKP treatment for OVCF in the Department of Spine Surgery of our hospital from January 2018 to January 2022. All patients were divided into the lateral decubitus group and the prone position group according to the decubitus position during cement injection. The imaging information and symptom indexes of the two groups were compared during treatment and follow-up. Results A total of 190 patients were enrolled in this study. Ninety-four patients received cement injections in the lateral decubitus position, while 96 patients were in the prone position. Compared with the prone position group, visual analogue scoring of pain (VAS scores) one week after surgery was significantly lower, grading distribution of cement distribution was better and cement leakage rate was significantly lower in the lateral decubitus group (P<0.05). At the last follow-up, the contralateral vertebral height in the lateral position group was significantly higher than that in the prone position group [(18.3±1.08) mm vs (17.4±1.03) mm, P<0.05]. Conclusions The lateral decubitus position can efficiently improve the distribution of cement in the elderly patients undergoing unilateral PKP, relieve acute pain better, reduce the incidence of cement leakage and the extent of the contralateral vertebra collapse in the long term.

Key words: lateral decubitus position, percutaneous kyphoplasty, cement distribution, osteoporotic vertebral compression fracture