Lollipop Technique for Treatment of osteoporotic vertebral compression simultaneous with pedicle fractures

<title>Abstract</title> <p> <bold>Objective</bold> : To evaluate the clinical efficacy and safety of the Lollipop technique (hollow screw–anchored bone cement augmentation) in the treatment of osteoporotic vertebral compression fractures accompanied by pedicle fractures (OVCPF). <bold>Methods</bold> : A retrospective study was conducted on 54 patients with OVCPF treated between May 2023 and March 2025. Patients were divided into two groups according to the surgical technique used: the anchoring group (n = 26), who underwent percutaneous kyphoplasty (PKP) combined with hollow screw anchoring following cement augmentation, and the non-anchoring group (n = 28), who underwent conventional PKP alone. Clinical and radiological outcomes were compared between the two groups, including operative time, cement volume, length of hospital stay, Visual Analog Scale (VAS) score, Oswestry Disability Index (ODI), anterior vertebral height, kyphotic angle, cement displacement rate, and incidence of adjacent vertebral fractures during a 12-month follow-up period. <bold>Results</bold> : No significant differences were observed between the anchoring and non-anchoring groups regarding operative time (52.1 ± 12.8 vs. 49.5 ± 11.7 min, p &gt; 0.05), cement volume (6.7 ± 0.9 vs. 6.6 ± 0.9 mL, p &gt; 0.05), length of hospital stay (3.9 ± 0.9 vs. 3.0 ± 0.4 days, p &lt; 0.05). Both groups demonstrated significant postoperative improvements in VAS scores, ODI, anterior vertebral height, and kyphotic angle compared with preoperative values (p &lt; 0.05). However, the anchoring group achieved significantly better maintenance of clinical and radiological outcomes during follow-up than the non-anchoring group (p &lt; 0.05). Furthermore, the anchoring group showed a significantly lower rate of cement displacement (4.5% vs. 16.3%, p &lt; 0.05) and a reduced incidence of adjacent vertebral fractures within 12 months (6.6% vs. 21.3%, p &lt; 0.05). <bold>Conclusions</bold> : This study is the first to evaluate a distinct subtype of osteoporotic vertebral compression fracture associated with pedicle fractures and demonstrates that hollow screw–anchored cement augmentation provides superior biomechanical stability and lower complication rates than conventional PKP. </p>