A Gathering of Titans to Celebrate a Momentous Event | Vertebroplasty Angulation Technique Debuts at the 12th Southern Spine Forum

The Third Academic Conference of the Spinal Surgery Professional Committee of the Guangdong Medical Education Association and the 12th Southern Spine Forum were grandly held in Guangzhou on November 6–7, 2021. A large number of renowned domestic experts in spinal surgery gathered in the “City of Rams” to deliver academic lectures and engage in in-depth discussions on new concepts, cutting-edge technologies, and emerging trends in the field of spinal surgery. The conference was organized by the Guangdong Medical Education Association and hosted by the Southern Hospital of Southern Medical University. In his opening address, Professor Zhang Zhongmin, Chair of the Conference, extended a warm welcome and heartfelt gratitude to all the participating experts and professors. Due to the ongoing pandemic, the event adopted a hybrid format, combining in-person and online sessions with multiple main and sub-venues. The on-site academic atmosphere was exceptionally vibrant, while online participation remained robust and steadily increasing. As the organizer of the main venue’s special forum on “Vertebroplasty Angulation Technique,” Ningbo Huake Run Biotechnology Co., Ltd. invited Professors Cao Zhenglin, Chen Luping, Wang Xinjia, and Yi Weihong to serve as moderators, and Professors Liu Hongjian, Meng Bin, Zhuo Xianglong, Li Ning, Gao Wenshan, and Chen Liang to deliver keynote presentations. The experts shared their insights and engaged in lively exchanges on the surgical techniques and clinical applications associated with vertebroplasty angulation.

The session commenced with a keynote lecture titled “Development and Clinical Application of Angled Vertebroplasty” delivered by Professor Liu Hongjian from the First Affiliated Hospital of Zhengzhou University. Professor Liu noted that osteoporotic vertebral compression fractures are the most common type of osteoporotic fracture, significantly compromising patients’ health and quality of life. To address the high mortality and disability rates associated with these fractures, as well as the vicious cycle inherent in conventional conservative management, vertebral augmentation techniques were developed. With the widespread adoption and advancement of percutaneous vertebroplasty and percutaneous kyphoplasty, angled vertebroplasty emerged as an innovative approach aimed at overcoming the limitations and challenges of traditional vertebroplasty. Professor Liu systematically outlined the R&D process of angled vertebroplasty, covering four key aspects: device design, ex vivo mechanical testing, finite-element analysis, and clinical trials. Through comparative studies involving standard PKP devices (single-sided, strongly oblique, and bilateral groups) and PCKP devices (angled group), he evaluated the advantages of angled vertebroplasty from multiple perspectives, including changes in vertebral height, micro-CT assessment of bone cement distribution, alterations in strength and stiffness, and outcomes in representative clinical cases. On this basis, he concluded that angled vertebroplasty is a safe, effective, and minimally invasive method for vertebral augmentation.

In his lecture titled “Controversies and Advances in Vertebroplasty,” Professor Meng Bin from the First Affiliated Hospital of Soochow University conducted a comparative analysis and research based on large-scale data, examining the controversies and evaluations of vertebroplasty outcomes as reported in both domestic and international literature. His findings confirmed the definitive therapeutic efficacy of vertebroplasty. In addition, he performed a comprehensive comparative analysis of domestic and international data and literature on key aspects such as the optimal timing of surgery, the volume and distribution of bone cement injection, the materials used for bone cement delivery, intravertebral expanders, and navigation technologies. Professor Meng highlighted that the use of angled balloons in clinical practice can reduce the number of fluoroscopic exposures and achieve uniform bilateral distribution of bone cement, demonstrating excellent clinical outcomes and warranting wider adoption.

In his lecture, “The Application of Augmentation Fixation in Osteoporotic Vertebral Fractures,” Professor Zhuo Xianglong from Liuzhou Workers’ Hospital presented four representative surgical cases. Through detailed case analyses, an overview of relevant examinations and diagnostic procedures, and a discussion of treatment-option selection, he systematically elucidated the surgical steps, intraoperative outcomes, postoperative recovery, and pre–postoperative comparisons. He concluded that combining bone-cement augmentation with pedicle-screw fixation not only alleviates pain and strengthens the vertebral body but also provides robust stabilization, making it a viable option for treating complex osteoporotic patients.

In his presentation, “Clinical Experience with Angled Vertebroplasty,” Professor Li Ning from Tianjin Hospital emphasized the significant clinical value of actively performing vertebroplasty in most patients with osteoporotic vertebral compression fractures, particularly those who are physically frail. Drawing on his own clinical experience and highlighting key technical points, Professor Li discussed the challenges associated with conventional bilateral puncture versus oblique-angle puncture, such as prolonged operative time, increased patient discomfort, and high technical demands. He pointed out that angled vertebroplasty effectively addresses these traditional operational difficulties by enabling single-sided puncture and multi-point cement injection for the treatment of compressive vertebral fractures. In a comparative analysis of conventional and angled puncture techniques, Professor Li used schematic diagrams illustrating the angled entry trajectory to explain that angled puncture also allows for targeted access through adjustment of the sheath orientation and rotation of the working channel; moreover, multi-point cement injection promotes more uniform distribution of bone cement.

Professor Liang Chen from the First Affiliated Hospital of Soochow University delivered a lecture titled “The Impact of Local Kyphosis on the Efficacy of Vertebroplasty.” Using surgical cases and a review of the literature, he analyzed the pathological mechanisms underlying local kyphosis and highlighted several postoperative cases in which vertebral height failed to recover, kyphosis persisted, and symptoms remained unrelieved. He concluded that, in single-level vertebroplasty, restoring both vertebral height and the Cobb angle is of paramount importance.

In his lecture, “Hot Issues in Percutaneous Vertebroplasty for Osteoporotic Vertebral Compression Fractures,” Professor Gao Wenshan of the Affiliated Hospital of Hebei University provided a historical overview of the evolution of vertebroplasty, covering such topics as its background and development, whether PVP has become obsolete, the choice between unilateral and bilateral puncture, selection of the target vertebral body, cement leakage, and postoperative follow-up management. He then offered a detailed discussion of the clinical application of vertebroplasty, concluding that, for the vast majority of PKP procedures, unilateral treatment is the standard recommendation, with bilateral treatment serving as an alternative or rescue option. The angled-approach vertebroplasty technique not only achieves the goals of bilateral puncture through a single-sided approach but also employs arc-shaped, uniform cement distribution that better aligns with the three-column support theory; in the long term, this can effectively reduce the incidence of re-fractures and yield superior postoperative outcomes.

Professors Cao Zhenglin, Chen Luping, Wang Xinjia, and Yi Weihong each delivered detailed commentary and shared their personal perspectives on the six distinguished lectures. Thanks to the robust support of all the professors—both online and in person—the special session on “Vertebroplasty Angulation Technique” was a resounding success. The conference was simultaneously livestreamed on the Haoyishu platform, attracting extensive attention from spinal surgeons across the country, with peak online viewership reaching 17,000. Huake Run will continue to advance along the path of indigenous innovation, injecting fresh momentum into the transformation of the orthopedic field and working hand-in-hand to build a brighter future.