Comparison Of PCVP And PVP In Treatment Of Osteoporotic Vertebral Compression Fracture

Objective: To compare the clinical effects of percutaneous curved vertebroplasty(PCVP)and percutaneous vertebroplasty(PVP)on the treatment of osteoporotic vertebral compression fractures(OVCF).Methods: A retrospective analysis was performed on patients undergoing PCVP and PVP(one-sided)techniques for treatment of OVCF in thoracolumbar spine.Sixty elderly patients with single-vertebral OVCF from January 2016 to January 2017 were selected as The subjects,they were divided into PCVP group(30 cases)and PVP group(30 cases)according to the operation method.There was no significant difference in gender,age and bone mineral density among the two groups(P> 0.05).The operation time,the amount of bone cement injection and the pain visual analogue scale(VAS score)at day after surgeryat and at sixth months postoperatively were compared between two groups,The CT was reviewed on the second postoperative day.The rate of bone cement crossing the vertebral sagittal midline and bone cement leakage rate of the two groups were evaluated.The above indexes were accurately recorded and statistically analyzed.Results: The operation time of group PCVP(38.1 ± 7.2min)was not statistically significant compared with that of group PVP(Unilateral)(37.2±7.6 min),and there was no significant difference in the amount of bone cement injection(3.61±1.36ml)in group PCVP(3.61 ± 1.36ml)compared with that of group PVP(3.53 ± 1.43ml).The preoperative PCVP group(visual analogue score for pain)was 7.9±1.3,while the preoperative VAS score of group PVP was 7.8±1.2.There was no significant difference between the two groups(P>0.05).The VAS score of group PCVP second days after operation and 6 months after operation was 1.9±0.8 and 1.5±0.7 respectively,while the VAS score of second days after operation and 6 months after operation in group PVP was 2.1±0.9 and 1.7±0.8,respectively,and VAS scores in second days and postoperative months after operation were significantly better than those before operation,with statistical significance(P<0.05)in VAS score group.There was no statistical significance(P>0.05),and there was no significant difference between the two groups at the same time point(P>0.05).The bone cement leakage rate of group PCVP(10﹪,3/30)was not statistically significant compared with that of group PVP(16.67﹪,5/30)at second days after operation(P>0.05).The distribution rate of bone cement center in group PCVP(100﹪,30/30)was statistically significant compared with group PVP(70﹪,21/30)(P<0.05).Conclusion: Both PCVP and PVP can obviously improve the symptoms of pain in OVCF patients,avoid the occurrence of severe complications such as pressure sore,bed,fracture nonunion,thrombus and pneumonia,so that patients can get out of bed at an early date and improve the symptoms of osteoporosis in patients.However,compared with PVP,PCVP is simpler and easier to operate.The operator can complete the operation only by mastering the basic pedicle screw placement technique.PCVP unilateral puncture can achieve the ideal distribution of bilateral bone cement in the vertebral body.The operator does not need to increase the angle of the puncture needle,which reduces the risk of puncture needle puncture the inner wall of the pedicle and damages the spinal cord and nerve root,and also reduces the trauma caused by bilateral puncture.The injection area of PCVP bone cement is larger than that of PVP,and the arc uniformity of the bone cement in the vertebral body is realized.Because of its continuous low pressure injection,the increase of cement leakage is avoided.It is particularly important that the distribution of PCVP bone cement center is obviously better than that of PVP,which makes the bilateral anti stress strength of the affected vertebra tend to be balanced,the distribution of bone cement is more in accordance with the biomechanical properties,which increases the strength of the bearing area and provides the ideal biomechanical support,and the cement along the front edge of the vertebral body is more consistent with the three column support.On the point of view.In short,PCVP has the advantages of small trauma,quick recovery,high safety,less complications and positive effect.It is a safe,effective and worthy of minimally invasive surgical treatment.