A Comparitive Study On Clinical Therapeutic Effects Between The System Of Percutaneous Vertebral Body Augmentation Using High Viscosity Bone Cement And Kyphoplasty

Objective:To observe the differences in clinical effects and operation safety between Percutaneous Vertebral Body Augmentation using high viscosity bone cement branding confidence and Percutaneous Kyphoplasty (PKP) in the treatment of osteoporotic vertebral compression fractures.Methods:From June2012to August2013,56patients with osteoporotic vertebral compression fractures (69hurted vertebral bodies),32males and24females, were treated with the system of Percutaneous Vertebral Body Augmentation using high viscosity bone cement (35cases) and Kyphoplasty (34cases). The subjects aged between55and91, averaging69.2years old.69hurted vertebral bodies were treated by vertebral plasty,1case of T11,7cases of T12,23cases of L1,9cases of L2,16cases of L3,13cases of L4. The anterior, midline and posterior heights of the hurted vertebral body, kyphosis cobb angle, visual analog scale (VAS) of pain were measured at preoperation and postoperation. The adverse event indexes like bone cement leakage rate, operation time, the injected bone cement volume, hemorrhage volume were kept record during and after operation. The obtained data of the anterior, midline and posterior height of hurted vertebral body, kyphosis Cobb angle, visual analog scale (VAS) of pain were calculated and analyzed by SPSS. For the data meeting normal distribution test, SPSS would perform T test; otherwise, nonparametric rank sum test would be performed.Results:All the incisions healed by first intention. There was no postoperative complications in any cases. In the PKP group there were3cases of bone cement leakage, including two cases of cement leakages into soft tissue around vertebral body and one case of leakage into intervertebral disc. In contrast, Confidence group found two cases of bone cement leakage into soft tissue around vertebral body.The analysis results of average height of vertebral body, kyphosis Cobb angle, VAS, bone cement leakage rate, operation time, the injected bone cement volume and hemorrhage volume are as follows (see Table1for the data):PKP group:The preoperative average height of vertebral body is24.66±4.56mm, the postoperative average height of vertebral body being27.45±3.56mm. The preoperative average kyphosis Cobb angle is10.60±7.91°, with the postoperative kyphosis Cobb angle averaging7.82±7.50°. The postoperative average VAS is7.85±1.41, the postoperative average VAS being0.81±0.93. The average improved height of vertebral body after operation is2.79±2.36mm(p＜0.05), with the improved kyphosis Cobb angle averaging and improved VAS averaging0.78±4.02°(p＜0.05) and7.04±1.75(p＜0.05) respectively. The average leakage rate of bone cement is11%.Confidence group:The preoperative average height of vertebral body is24.56±4.34mm, the postoperative average height of vertebral body being27.07±3.43mm. The preoperative average kyphosis Cobb angle is11.73±6.34°, with the postoperative kyphosis Cobb angle averaging9.95±5.33°. The postoperative average VAS is7.76±1.21and the postoperative average VAS is1.05±1.55. The average improved height of vertebral body after operation is2.52±2.36mm(p<0.05), and the average improved kyphosis Cobb angle is1.78±3.65°(p＜0.05). The average improved VAS is6.71±1.96(p＜0.05), while the average leakage rate of bone cement is9%.All in all, no significant differences are found between the two groups in terms of improved height of vertebral body, improved kyphosis Cobb angle,improved VAS and leakage rate of bone cement.Conclusion:In the treatment of osteoporotic vertebral compression fractures, the high viscosity bone cement treatment has similar effects as PKP on the recovery of the height of vertebral body and kyphosis cobb angel, pain relief and prevention of bone cement leakage.