The Clinic Study Of Percutaneous Vertebroplasty In The Treatment Of Severe Osteoporotic Vertebral Compression Fracture

Objectives: To compare the clinical outcomes of patients with severe thoracolumbarwedge-shaped OVCF treated by PVP or conservative treatment.Methods：From January2008to June2010, a total of43patients met our criteria andnonrandomly assigned to undergo PVP or conservative treatment. Clinical outcomeswere determined by VAS and SF-36. Vertebral height, kyphotic angle and cement leakagewere assessed by radiography while new OVCFs by MRI.Results: All of the43patients had follow-up for at least1year. The baseline clinical andradiological characteristics of both groups were comparable. PVP group, in compare withthe conservative treatment group, turns out to have greater improvement in VAS and PCS， together with anterior and central vertebral height and kyphotic angle atall postoperative intervals, while no significant differences were found between twogroups with regard to posterior vertebral height and new OVCFs incidence, as well asMCS except for the first month after treatment. Asymtomatic cement leakage occurred in52.63%(10/19)of the treated vertebrae in PVP group and70%of them placed in theintervertebral disc. New OVCFs can be found53days earlier in PVP group thanconservative group.Conclusions: PVP is technically feasible in the treament of severe thoracolumbarwedge-shaped OVCF in spite of higher but asymtomatic leakage incidence. Pain relief andphysical function improvement after PVP are immediate, substained and significantlygreater than that achieved with conservative treatment without increasing risk of newOVCFs. Objectives: To compare the clinical outcomes of patients with severe or non-severveosteoporotic vertebral compression fracture after percutaneous vertebroplasty (PVP)..Methods：From January2008to January2012,35patients with severe OVCF and232patients with non-severe OVCF met our criteria and underwent PVP. Clinical outcomeswere determined by pain Visual Analogue Scale (VAS) and Oswestry Disability Index(ODI). Vertebral height, kyphotic angle and cement leakage were assessed by radiographywhile new OVCFs by MRI.Results: All of the267patients are followed-up for3~46months after PVP, both of thetwo groups result in a significant improvement in VAS and ODI without differancebetween each other. However, non-severe OVCF group, in compare with the severeOVCF group, turns out to have greater improvement in anterior and central vertebralheight and kyphotic angle,together with lower incidence of cement leakage and newOVCFs.Conclusions: PVP is effective in both severe and non-severe OVCF.Higher incidence ofcement leakage and new OVCFs in the treatment of severe OVCF should be noticed andevaluated before the surgery.