The Correlation Between The Degree Of Injured Vertebrae And The Curative Effect Of PKP In Elderly Osteoporotic Fractures

Objective:The study reviewed patients who had undergone percutaneous kyphoplasty(PKP)due to elderly osteoporotic thoracolumbar compression fractures,analyzed preoperative and postoperative imaging and mid-to long-term follow-up data.Comprehensive evaluation of the relationship of patients with different degrees of kyphotic angle(Cobb angle)after PKP postoperative kyphosis deformity,to provide scientific basis for the selection of Cobb angle before PKP operation and further clinical application.Methods:The complete data of elderly patients with osteoporotic compression fractures who were hospitalized in our department from June 2017 to June 2020 and undergo single-segment PKP surgery were selected.All of them met the inclusion criteria.A total of 100 cases were included,including 42 males and 58 females,aged 52-76 years,average(63.45±5.53)years old,32 cases involved the thoracic spine and 58 cases involved the lumbar spine.According to the preoperative lateral X-ray of standing position,the angle formed by a vertical line(Cobb angle)of the upper endplate connection of the injured vertebrae and the connection of the lower endplate of the injured vertebral body was made,and the patients were divided into Group A(Cobb angle<20°),Group B(Cobb angle 20-30°),Group C(Cobb angle>30°)3groups,including 38 cases in group A,32 cases in group B,and 30 cases in group C;All patients underwent anti-osteoporosis treatment.The 3 groups of patients received X-ray examination at 1 day,1 month and 12 months after operation.By comparing the pre-and post-operative cobb correction rate and the height of the anterior edge of the vertebral body The improvement rate and other parameters,visual analogue scale(VAS)and Oswesty dysfunction index(ODI)were used to evaluate the treatment effect,and the influence of preoperative cobb angle on PKP treatment of kyphosis was analyzed.Results:1.3 Comparison of general data of patients in the group,the difference was not statistically significant(P>0.05)2.The scores of VAS and ODI in the 3 groups before operation were not statistically significant(P>0.05);the scores of VAS and ODI in the 3 groups were significantly improved at 1 day,1 month,and 12 months after operation.All are statistically significant(all P<0.001)3.The difference in the height of the anterior edge of the vertebral body in the 3groups before operation was statistically significant(P<0.05).After the operation,the height of the anterior edge of the vertebral body in groups A and B was significantly improved compared with that before operation,and the difference was statistically significant(all P<0.05).0.05),the height of the anterior edge of the vertebral body after operation in group C was not significantly improved compared with that before operation,and the difference was not statistically significant(P>0.05)4.The difference in Cobb angles between the 3 groups before operation was statistically significant(P<0.05),and the Cobb angles of the vertebral bodies in groups A and B were significantly improved after the operation,and the differences were statistically significant(all P<0.05),C The postoperative Cobb angle was not significantly improved compared with the preoperative group,and the difference was not statistically significant(P>0.05)5.Recurrence of vertebral body fracture: During the follow-up period,10 patients had recurrence of adjacent vertebral body fractures,including 1 case in group A,2 cases in group B,and 7 cases in group C.Conclusions:1.The pain of the three groups of patients was significantly improved compared with that before the operation.Group B(Cobb angle of 20°-30°)had the best improvement effect,and group C(Cobb angle of greater than 30°)had the worst effect.2.The height of the anterior edge of the vertebral body of the three groups was improved compared with that before the operation.The results showed that the height of the vertebral body in group B was restored the best,and the height of the vertebral body in group C was the worst.3.The Cobb angle correction rate of the three groups of patients was significantly different after the operation.The Cobb angle correction rate of group B(Cobb angle20°-30°)was the best,and the Cobb angle correction rate of group C was not significantly improved compared with that before operation.The improvement rate of the anterior edge of the vertebral body is the same.