A Comparative Study Of Percutaneous Vertebroplasty In The Treatment Of Acute Osteoporotic Vertebral Compression Fractures With And Without Intravertebral Cleft

Objective: To evaluate the efficacy of percutaneous vertebroplasty in the treatment of acute osteoporotic vertebral compression fractures with or without intravertebral cleft.Methods: A retrospective analysis was conducted on 111 patients with acute osteoporotic vertebral compression fractures who met the criteria from March 2017 to December 2018.cleft group(n=28)and non-cleft group(n=83).The operation time,the injected volume of bone cement,bone cement leakage and adjacent vertebral re-fracture were recorded.The visual analogue scale(VAS)score、Oswestry disability index(ODI)system、height of anterior vertebral body and the posterior convex Cobb angle of injured spine were used to evaluate the effect of the operation respectively at pre-operation、post-operation and last follow-up period.Results: There was no significant difference in gender,age,bone mineral density,injured vertebral segment between 2 groups(P>0.05).There were 15 cases of bone cement leakage in group with intravertebral cleft,the leakage rate of 53.57%;22cases of bone cement leakage in group without intravertebral cleft,the leakage rate of26.51%,The difference between the two groups was statistically significant(P<0.05).There were 2 cases of adjacent vertebral body re-fracture in the group with intravertebral cleft,the re-fracture rate was 7.14%;3 cases in the group without intravertebral cleft,the re-fracture rate was 3.61%.There was no significant difference between the two groups(Purge 0.599).The VAS score,ODI,height of anterior vertebral body and the posterior convex Cobb angle of injured spine were improved compared with those before operation.The difference was statistically significant(P<0.05).VAS score,ODI,height of anterior vertebral body and Cobb Angle of injured vertebral body were all improved between the two groups after surgery and at the last follow-up,with no statistical significance(P<0.05).There were no significant differences in VAS score,ODI,height of anterior vertebral body and the posterior convex Cobb angle of injured spine between the two groups(P>0.05).Conclusion: PVP in the treatment of osteoporotic vertebral compression fractures with and without intravertebral cleft can effectively relieve pain and improve function,and restore the height of the anterior edge of vertebral body and Cobb angle of kyphosis to some extent.The leakage rate of bone cement in the group with intravertebral cleft was higher than that in the group without intravertebral cleft,but the leakage of bone cement did not cause obvious clinical symptoms.The re-fracture rate of adjacent vertebrae in the group with intravertebral cleft was higher than that in the group without intravertebral cleft,but there was no significant difference between the two groups.