| Part I The effective of percutaneous kyphoplasty treatment inosteoporotic vertebral compression fractures patients.Objective: To observe the clinical efficacy and complications of the treatment of osteoporotic vertebral compression fracture(OVCF) with the method of percutaneous kyphoplasty(PKP).Methods: 203 patients with osteoporotic vertebral compression fractures were treated by PKP during January 2008 to September 2012. All the patients were divided into osteopenia group and osteoporosis group according to preoperative detection of bone mineral density, and reviewed by visual analogue score(VAS),Roland-Morris disability survey scale(RDQ) and cobb angle. All data were analyzed using SPSS17.0.Results:In all,203 patients were enrolled in this study.Follow-up lasted for 36-96 months.The VAS score descended from(7.7±2.0)to(4.2±2.3) 3 days after operation,(2.6±2.7)3 months after operation,(2.2±1.9)1 year after operation,(2.5±2.7)2 years after operation,(4.3±2.5)3 years after operation.The RDQ score descended from(21.0±1.8)to(11.0±1.9)3 days after operation,(5.8±2.4)3 months after operation,(6.9±2.0) 1 year after operation,(8.7±3.0)2 years after operation,(12.6±2.5)3 years after operation.The height of vertebral body compression rate descended from(45.0±12.6)%to(3.0±2.8)% 3 days after operation,(3.2±2.9)% 3 months after operation,(4.0±2.6)% 1 year after operation,(5.1±4.2)% 2 years after operation,(5.7±3.6)% 3 years after operation;the cobb angle descended from(22.4±9.0)?to(7.2±2.5)3 days after operation,(7.3±3.4)3 months after operation,(7.5±3.6)1 year after operation,(8.8±3.5)2 years after operation,(10.1±4.6)3 years after operation.TConclusion:PKP is one obvious effect of treatments for osteoporotic vertebral compression fractures of the small kind of trauma treatment, in the short term can quickly relieve pain and improve patient quality of life of patients.Part II The effect of alendronate sodiumon the incidence of spinal re-compression fracture after PKP Objective: To explore the effect of alendronate sodiumon the incidence of spinal re-compression fracture after PKP.Methods: We reviewed 203 cases of osteoporotic vetebral compression fractures which were treated with PKP from January 2008 to February 2012. 203 cases were divided into study group and control group. The patients of study group were treated with alendronate sodium. The patients of control group were not treated with alendronate sodium. X rays were taken in 3 months, 6 months and 12 months after PKP to determine whether spinal fracture occured again.Results: The total incidence of spinal re-compression fracture was 7.88%, male 3.50%,while female 9.59%. Chi-square test was used to analysis the re-compression fracture after PKP. The results showed that the incidence of re-compression fracture of study group was lower than that of control group, and the difference was significant. The incidence of re-compression of study group and control group were 4.80% and 12.82% respectively.The incidence of re-compression of women in study group and control group were 5.62%and 15.79% respectively, and the difference was significant. The incidence of re-compression of men in study group and control group were 2.78% and 4.76%respectively, and the difference was not significant.Conclusion: Giving alendronate sodium is helpful in decreasing the incidence of re-compression of women after PKP.Part III Biomechanical properties of injectable cement in cadavericosteoporotic vertebral fracture.Objective : To evaluate the biomechanical performance of two kinds of cement for vertebroplasty in cadaveric osteoporotic vertebral bodies.Method : 25 vertebral bodies from 5 osteoporotic cadaveric spines were signed to 3groups: Group A―no cement; Group B―PMMA; Group C―CSC. Each vertebral body was stripped of soft tissue and the posterior elements removed, and the bone mineral density(BMD), initial height of each body were measured. Each vertebral body was compressed on a material testing machine to create an anterior wedge fracture and reducethe anterior height by 25%. Pretreatment strength and stiffness were measured. Drilling a hole and then PMMA was injected in group B; CSC was injected in group C. All vertebral bodies were recompressed by 25% of anterior height to obtain posttreatment strength,stiffness and height.Results : There were no significant differences in BMD, initial strength and initial stiffness of vertebrae between the 3 groups. After cement augmentation, the height and strength of the augmented vertebrae was significantly greater than blank control(p<0.05).Group B is closer to initial strength. The stiffness of the augmented vertebrae was significantly greater then that of the blank control, but it was not restored to the initial level.Conclusion: PMMA as a new bone graft substitute material can restore the height and strength of vertebral body, it can restore initial stabilization. |
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