Clinical Efficacy Analysis Of Percutaneous Kyphoplasty For Osteoporotic Vertebral Compression Fracture At Different Surgical Timing

Objective :To compare the clinical effect of percutaneous kyphoplasty(PKP)in the treatment of osteoporotic vertebral compression fractures(OVCFs)at different operation time and to explore the appropriate operation time of PKP,so that patients can get more clinical treatment benefits.Methods:143 OVCFs patients who met the inclusion criteria and underwent PKP treatment from January 2018 to December 2019 in our hospital were selected and divided into three groups: There were 58 patients who underwent operation in less than 7 days from fracture to operation(group A),44 patients who underwent operation in 7 to 14 days from fracture to operation(group B),41 patients who underwent operation in 14 to 30 days from fracture to operation(group C).We collected the clinical data of the three groups and compared the pain visual analogue scale(VAS),Oswestry disability index(ODI),vertebral compression rate,Cobb angle and its improvement rate,bone cement dispersion and complications.Result:Differences are not significant in age,gender,combined medical diseases and bone cement injection volume among the groups(P >0.05).The VAS score and ODI index were declined continuously after operation(P < 0.05).Compared with group B and group C,the VAS score and ODI index of group A was lower on the third day after operation(P < 0.05).The VAS score and ODI index of group B was lower than group C on the third day after operation(P < 0.05).The anterior vertebral compression rate and Cobb angle of group A were significantly improved on the third day after operation(P <0.05).The anterior vertebral compression rate and improvement rate in group A were better than group B and group C(P < 0.05).Cobb Angle of group A was better than that of group C on on the third day after operation,and the improvement rate of Cobb Angle of group A was better than that of group B and C,meanwhile,group B was better than that of group C(P < 0.05),The bone cement leakage rate in three groups was 15.4%,Group A was significantly higher than group B(P < 0.05);Statistically significant differences showed between the three groups in the distribution shape of bone cement and whether or not reaching the upper and lower endplates(P < 0.05),and early operation showed better dispersion of bone cement;In terms of long-term bed rest complications,The incidence of deep vein thrombosis(DVT)was 9.1%.The incidence increased with the prolongation of operation time,and statistically significant difference showed between group A and group C(P <0.05),No significant difference showed in the rate of urinary tract infection among the three groups(P>0.05).Conclusion:The patients who received PKP surgery within one month after fracture can satisfactorily relieve pain,improve vertebral height and Cobb Angle;DVT is a complication of OVCFs that can not be ignored and the incidence increases significantly with the prolongation of operative timing;The patients who received surgery early can relieve pain,improve vertebral morphology and result in better cement diffusion,while delaying surgery to 1-2 weeks can reduce cement leakage.