title: A novel technique of unilateral percutaneous kyphoplasty achieves effective biomechanical strength and reduces radiation exposure.
abstract: OBJECTIVE
  To develop a novel technique of percutaneous kyphoplasty (PKP) with effective biomechanical strength and lower radiation exposure.
  
  
  METHODS
  Thirty fresh lumbar vertebrae isolated from six hogs were decalcified and compressed to induce osteoporotic vertebral compression fractures. Kyphoplasty was performed using three different techniques (ten for each group): conventional unilateral approach (group A), conventional bilateral approach (group B) and novel unilateral approach (group C). Biomechanical indexes including Yield load and stiffness were tested before and after kyphoplasty. The anterior height of each vertebral body (AHVB) was measured before compression, after compression and after kyphoplasty. Frequency of C-arm use and volume of bone cement were also recorded in the process.
  
  
  RESULTS
  Compared with group A, our novel technique in group C can significantly improve the recovery of AHVB after compression fractures. However, there was no statistical difference between group B and group C. Values of Yield load in both group B and group C were statistically higher than that in group A, however, no significant difference was found between group B and C. Statistical results of stiffness were similar to Yield load. Regarding volume of bone cement and radiation exposure, the novel technique in group C needed more bone cement and fluoroscopy use than in group A but less than in group B.
  
  
  CONCLUSIONS
  This novel device makes unilateral kyphoplasty feasible, safe and effective. In the premise of guaranteed biomechanical strength, the new technique significantly reduces risk of radiation exposure in kyphoplasty.
authors.affiliation: Department of Orthopedics, The First Affiliated Hospital of Nanjing Medical UniversityNanjing, China; Department of Orthopedics, The Affiliated Jiangyin Hospital of Southeast University Medical CollegeWuxi, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhuang
authors.affiliation: Department of Orthopedics, The First Affiliated Hospital of Nanjing Medical University Nanjing, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Yang
authors.affiliation: Department of Orthopedics, The Taizhou People's Hospital Affiliated to Nantong University Taizhou, China.
authors.forename: Haijun
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Orthopedics, The Affiliated Jiangyin Hospital of Southeast University Medical College Wuxi, China.
authors.forename: Yajun
authors.initials: Y
authors.lastname: Ren
authors.affiliation: Department of Orthopedics, The First Affiliated Hospital of Nanjing Medical University Nanjing, China.
authors.forename: Xiaojian
authors.initials: X
authors.lastname: Cao
keywords: Compression fracture; biomechanics; bone cement leakage; radiation exposure; unilateral percutaneous kyphoplasty