Comparison Of Mid-and-long-term Curative Effect Of Conservative Treatment And Vertebroplasty For Middle Thoracic Osteoporotic Compression Fractures

Objective This study aims to explore the mid-and-long-term efficacy differences between percutaneous kyphoplasty(PKP)treatment of middle thoracic osteoporotic vertebral compression fractures(mt OVCF)and conservative treatment.Methods A retrospective analysis of 102 patients with osteoporotic compression fractures of the middle thoracic spine(L5-L8),aged between60-87 years(average age 72.31 years).All patients were divided into surgical group and conservative group according to the treatment method.The preoperative body mass index(BMI),bone mineral density(BMD)and the proportion of injured vertebral body were recorded and calculated.The pain visual analogue score(VAS),Oswestry dysfunction index(ODI),local kyphosis angle(LKA),vertebral compression ratio and adjacent vertebral fracture were recorded during the follow-up period.Results All cases were followed up for more than 2 years.The VAS score and ODI score were significantly improved after conservative treatment and PKP compared with those before treatment.And the improvement of pain was continuous as a whole.The height of injured vertebrae in the operation group was corrected immediately after operation,but the height of injured vertebrae after operation was lower than that after operation at 1 month,but there was no significant difference between the last follow-up and 1 month after operation.In the conservative group,the height of injured vertebrae did not decrease significantly at 1 month after treatment,but decreased significantly at the last follow-up(p < 0.05).In the operation group,LKA was corrected immediately after operation,and LKA after operation at 1 month was corrected compared with that before operation(p < 0.05),but it was higher than that at 3 days after operation(p< 0.05).At the last follow-up,LKA was not significantly different from that before operation(p < 0.13).There was no significant difference in LKA between one month after treatment and before treatment in the conservative group,and the LKA in the last follow-up was significantly higher than that before treatment(p < 0.05).During the follow-up period,there were 20 cases(25.30%)of adjacent vertebral fractures(AVF)in the operation group and 1 case(4.30%)in the conservative group,and the risk of adjacent vertebral fractures in the operation group was higher than that in the conservative group(p < 0.05).Conclusion Conservative treatment and PKP surgery are both effective methods for the treatment of mid-thoracic compression fractures.PKP surgical treatment recovers quickly,and you can get out of bed early after surgery,but the risk of afjacent vertebral fractures is high;conservative treatment takes a long time,but the risk of afjacent vertebral fractures is relatively small.