| Objective: To investigate the efficacy of PKP in the treatment of osteoporotic vertebral compression fractures with or without intravertebral cleft and the effect of intravertebral cleft on postoperative results of PKP.Methods: This study retrospectively analyzed a total of 263 patients with osteoporotic vertebral compression fractures who underwent percutaneous kyphoplasty in our hospital from January 2016 to December 2017.All patients underwent preoperative X-ray,CT,magnetic resonance imaging(MRI)and bone mineral density measurement.According to the preoperative imaging results,there were 62 patients in the fracture sign group(group A)and 201 patients in the non-fracture sign group(group B).Postoperative follow-up averaged 25.5 months.Visual analogue scale(VAS)and Oswestry dysfunction index(ODI)were used to evaluate the postoperative effects.Through the analysis of two groups of patients with basic information(sex,age,height,weight,BMI,bone mineral density T value,high blood pressure,diabetes),surgery(number of injured vertebral,operation time,preoperative fanterior flange height,preoperative vertebral rear height,postoperative fanterior flange height,the height of the vertebral rear,bone cement dosage,lobe after preoperative and postoperative after convex Angle)and postoperative complications(leakage of bone cement and bone cement displacement,postoperative fracture)such as indicators to evaluate with or without fracture of osteoporotic vertebral compression fractures after PKP holds effect and vertebral body fracture of PKP holds the postoperative effect.Results: 1.Basic data results:There were 62 patients in group A,including 20 males and 42 females.The average age was 71.37±7.24 years old,and there were 201 people in group B(group B)without fracture signs,including 68 males and 133 females.The average age was 72.31±9.34 years.There was no significant difference in gender,age,height,weight,BMI,bone mineral density T value,hypertension and diabetes between the two groups(P>0.05).2.Results related to surgery: Compared with group B,the preoperative VAS score and ODI score of group A had no statistically significant difference(P>0.05),but the preoperative VAS score and ODI score of group A and group B were significantly lower than that of group B 3 days after surgery,and the difference was statistically significant(P<0.05).It showed that PKP was an effective method for the treatment of osteoporotic vertebral compression fractures with or without fractures,but there was no significant difference in VAS score and ODI score between the two groups during postoperative follow-up(P>0.05).There was no significant difference between group A and group B in the number of injured vertebrae,operation time,preoperative vertebral anterior margin height,posterior margin height,postoperative vertebral anterior margin height,postoperative vertebral anterior margin height,preoperative posterior convex Angle,postoperative posterior convex Angle and other indicators(P>0.05).However,in the last follow-up,the anterior vertebral height of the two groups was different(P<0.05).The anterior vertebral height of the two groups was compressed again in the last follow-up,but the compression degree of the group A was significantly higher than that of the group B.The degree of compression in group A was even more severe than that before surgery(P<0.05).The average amount of bone cement in group A was 5.0±1.8ml,and that in group B was 3.8±1.2ml.The amount of bone cement in the fracture sign group was significantly higher than that in the non-fracture sign group,and there was a significant difference between the two groups(P<0.05).3.Results of complications:There were 18 cases(29.1%)of bone cement leakage in the vertebral body fracture sign group(group A),and 54 cases(26.9%)of bone cement leakage without fracture sign(group B).Although the incidence of bone cement leakage in group A was higher than that in group B,the difference was not statistically significant(P>0.05).There were 2 cases of bone cement displacement in group A(3.2%)and 0 cases of bone cement displacement in group B(0%),with no statistically significant difference(P>0.05).There were 8 cases of adjacent vertebral fractures in group A(12.9%)and 21 cases of adjacent vertebral fractures in group B(10.4%).There was no statistically significant difference between the two groups(P>0.05).In group B,there were 18 cases(8.9%)of vertebral recollapse.The difference between the two groups was statistically significant(P<0.05).Conclusion: PKP can achieve good short-term results in the treatment of osteoporotic vertebral compression fractures with or without fractures,but the long-term effect in the vertebral fracture sign group is poor,the height of the anterior edge of the vertebral body is more easily compressed,and patients with OVCF with vertebral fractures are more prone to vertebral recollapse.Therefore,it is suggested to pay more attention to brace protection,anti-osteoporosis and other rehabilitation treatments after PKP in patients with vertebral fracture. |
PDF Full Text Request