| Objective: To compare percutaneous kyphoplasty(PKP) and conservative treatment of osteoporotic vertebral compression fractures had no control.Methods: 2013 5-2015 dated January Yan’an University Affiliated Hospital orthopedic treatment of osteoporotic vertebral compression fractures without obvious clinical data of 64 cases, in which the line kyphoplasty(PKP) 34 cases, 13 males and 21 females, aged between 55-89 years, mean 74.8 years; 30 cases treated conservatively, 8 males and 22 females, aged between 58-87 years, mean age 76.4 years old. Surgically treated patients were successfully completed, periodic review and follow-up after surgery, the patient understand the changes in the indicators, after conservative treatment of patients, in strict accordance with the principles of treatment, to keep abreast of developments and changes in the disease, but also to actively follow-up after discharge and regular review. By comparing the two groups of patients before and after treatment one week, one month, three months, six months of pain visual analogue scale(VAS), vertebral kyphosis(Cobb), Disability Index(ODI) of difference, while relatively ambulation time, length of hospital stay and complications in terms of differences in order to assess which treatment is more effective, provide a reference for clinical work.Results: All patients were successfully operated surgery, pain visual analogue scale(VAS), the conservative treatment group was as follows: pre-treatment(8.73 ± 2.40) points, one week after treatment(7.48 ± 1.90) points after treatment in January(3.94 ± 1.80) points, after 3 months of treatment(2.45 ± 1.30) points, after 6 months of treatment(0.88 ± 0.45) points; surgery group was as follows: preoperative(8.58 ± 1.80) points, after one week(2.46 ± 1.50) points, after 1 month(2.14 ± 1.40) points, after March(1.08 ± 1.20) points, after June(0.79 ± 0.25) points, ie, vertebral kyphosis Cobb angle, the conservative treatment group was as follows: before treatment 35.7°± 7.80°, one week after treatment 31.2°± 6.80°, 1 month after treatment 28.5°± 4.70°, after 3 months of treatment 25.7°± 3.80°, after 6 months of treatment 21.7°± 1.80 °; surgery group was as follows: preoperative 34.9°± 7.40°, after one week 23.6 °± 5.70°, after 1 month 22.3°± 5.20°, after March 21.8°± 4.30°, after June 21.3°± 1.70°, dysfunction index ODI average of the conservative treatment group: the former(80.3 ± 12.7)% after treatment one week(72.6 ± 10.8)%, 1 month after treatment(58.3 ± 13.6) % after 3 months of treatment(45.2 ± 11.3)%, after 6 months of treatment(31.8 ± 9.7)%, the surgery group was as follows: preoperative(79.6 ± 12.3)%, after one week(35.2 ± 12.9)%, surgery After January(34.3 ± 10.9)%, after the March(32.5 ± 8.9)%, after June(30.9 ± 10.4)%, the former conservative treatment group and the surgery group, after statistical tests and found that P> 0.05 representing the two groups before treatment of pain visual analogue scale(VAS), vertebral kyphosis angle(ie Cobb angle), the difference Disability Index(ODI) was not statistically significant, suggesting that the conservative group and treatment group were comparable. After 1 week, 1 month, 3 months, conservative surgery group after group and statistical analysis test, P <0.05, said the two groups after treatment 1 week, 1 month, 3 months, pain visual analogue scale(VAS), at one week after treatment, in January, March, these three indicators surgical patients reduce vertebral kyphosis angle(ie Cobb angle), the difference Disability Index(ODI) was statistically significant, indicating that the more Conservative group obviously. After 6 months, the conservative group and the surgery group, after statistical analysis test, P> 0.05, in June, said the two groups after treatment, the pain visual analogue scale(VAS), vertebral kyphosis angle(ie Cobb angle) functional disability index(ODI) showed no significant difference, indicating that change in June of two treatment regimens in patients with no significant difference between these indicators. Tip surgery could significantly reduce the patient’s pain visual analogue scale(VAS), vertebral kyphosis angle in a short time(ie Cobb angle), functional disability index(ODI). Conservative treatment group ambulation average(15.40 ± 5.70) days, the average length of stay was(21.80 ± 4.50) days, complications occurred in 5 cases, including two cases of pulmonary infection, two cases of urinary tract infections, one case of bedsores. Surgical treatment group ambulation average of(2.30 ± 1.10) days, the average hospitalization time was(7.49 ± 2.50) days, three cases of complications, both cement leakage, but no neurological symptoms, there is no pulmonary embolism and other complications. Surgical group in ambulation time, length of hospital stay compared with conservative treatment has obvious advantages, the difference was statistically significant(p <0.05).Conclusion: For patients with senile osteoporotic vertebral fractures, conservative treatment and kyphoplasty(PKP) long-term effects can relieve pain and improve function disorders, improve the quality of life of older persons, the exact clinical effect, sure. Although conservative treatment is a noninvasive treatment, but poor short-term effects, severe pain, a longer treatment period, and bedridden, can lead to pressure ulcers, lung infections, urinary tract infections, deep vein thrombosis and other complications, ambulation time later, long hospital stay, patients and their families to enormous mental and financial burden. With the development and application of minimally invasive techniques, kyphoplasty(PKP) is a kind of analgesic effect precise, rapid operation is relatively simple treatment, the majority of patients likely to be accepted, and in the vertebral body height restoration, early ambulation time, shorter hospital stay and other advantages, in short. The results of the study show that, PKP superior to conservative therapy in the treatment of osteoporotic vertebral fractures, worthy of clinical application. |
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