| Objective:Osteoporosis is a reduction of bone mineral composition and bone matrix proportion.By thinning trabecular bone quantity for pathologic features, and bone fragility will easily result in a fracture disease of the whole body. Lumbar back pain is the most common clinical manifestations.The pain diffusions to the both sides,and relief after lie supine, but aggravate after a long standing or rear protraction. The most common and most serious complications of osteoporosis is the fractures which causes the thoracic region,lumbar region,thoracolumbar and disseminately spine ache. With the rapid development of modern medical technology. percutaneous kyphoplasty has become to the first choice in treating osteoporotic compressed fractures in nowadays. Due to its minimally invasive surgical methods and significant analgesic effect, percutaneous kyphoplasty is widely accepted by patients and obtains an rapid development.Whether discrepancy is existented between unilateral and bilateral percutaneous kyphoplasty,different experts have different ideas.The aim of this research is to make a comparison on unilateral and bilateral,so as to reach a conclusion on whether is there any difference between them.Methods:Totally 128 patients with osteoporotic vertebral compression fractures operated by balloon kyphoplasty from July 2007 to February 2009 at the Third Clinical Hospital of Hebei medical university were retrospectively analysed. 97 patients received more than 1 years of follow-up.They were divided into two groups on the basis of unilateral or bilateral of transpedicular operations. The unilateral group included of 9 men and 39 women with an average age of 65.3 (range 50 to 87 years old). Only one vertebrate was involved in 36 cases, two vertebrates were involved in 17 cases, three veterbrates were involved in 5 cases. The bilateral group included of 5 men and 34 women with an average age of 67.1 (range 52 to 88 years old). one vertebrae was involved in 24 cases, two vertebrates were involved in 14 cases, three veterbrates were involved in 1 case.Each procedure included insertion of inflatable balloon, fracture reduction and cement filling under"C"-arm monitoring.Preoperative and postoperative pain level, reduction of the fracture ,correction of kyphotic deformity and complication were recorded and analyzed.Results: All patients tolerated the operation well. The average operation time were (84±36)min and (110±27)min for unilateral and bilateral groups respectively,and the mean volume of cement injected into one level were(3.5±1.7)ml and(4.7±2.1)ml for unilateral and bilateral groups respectively. The mean follow-up were(20±2.6)months and(18±3.1)months for unilateral and bilateral groups respectively.The mean VAS pain score of unilateral group decreased significantly from 8.1±2.5 preoperatively to 2.6±1.8 postoperatively(t=13.597, P<0.05) and 2.9±2.1 at final follow-up, the mean VAS pain score of bilateral group decreased significantly from 8.2±2.1 preoperatively to 2.7±2.2 postoperatively(t=11.293, P<0.05) and 2.8±2.0 at final follow-up.The height of anterior border, center pillar had a remarkable increase compared to preoperative,and sustained to the last follow-up, there were statistical significance differences(P<0.05).The mean cobb′s angle of unilateral group rectified distinctly from 34±7.5o preoperatively to 22±5.8o postoperatively; the mean cobb′s angle of bilateral group rectified distinctly from 33±8.1o preoperatively to 20±6.7o postoperatively. comparing to each group there were statistical significance differences between the postoperative and the preoperative(P<0.05). However,comparison between the two groups, there were no statistical significance differences(P>0.05). The mean activity ability score of unilateral group improved from 2.87±0.75 preoperatively to 1.30±0.34 postoperatively and 1.43±0.52 at final follow-up,the bilateral group improved from 2.75±0.83 preoperatively to 1.26±0.41 postoperatively and 1.39±0.47 at final follow-up. comparing to each group there were statistical significance differences between the postoperative and the preoperative(P<0.05). There were 8 cases (11 segments)occured cement leaks among the 97 patients,and 1case pulmonary embolism without any symptoms.Conclusion: According to the study,whether implement unilateral or bilateral balloon kyphoplasty in treating osteoporotic vertebral compression fractures can obtain satisfactory therapeutic effects.Due to its simple operating method, high safety, rapidly alleviate the patients′pain, and decrease the analgesics dependence.PKP can obviously improve the quality of patients′life. |
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