Clinical Studies Of Kyphoplasty In Treatment Of Thoracolumbar Osteoporotic Vertebral Compression Fractures

PART I Kyphoplasty versus Conservative Treatment for Thoracolumbar Osteoporotic Vertebral Compression FracturesObjective:To observe and compare the clinical effect of kyphoplasty versus conservative treatment on patients with thoracolumbar osteoporotic vertebral compression fractures.Methods:From March 2013 to August 2013 in our hospital,136 cases of thoracolumbar osteoporotic vertebral compression fractures were treated by kyphoplasty,104 cases of thoracolumbar osteoporotic vertebral compression fractures were treated by conservative treatment.These patients were divided into surgical group(n=13 6)and control group(n=104).Kyphoplasty was conducted in surgical group and conservative treatment was conducted in control group.Outcome data(Visual Analog Scale[VAS]scores,Oswestry Disability Index[ODI]scores,Cobb angle,mean variation of anterior and middle vertebral body height)were recorded preoperatively,postoperatively,and at 2 month,12 months,and 2 year after treatment,to evaluate the results.Results:VAS scores,ODI scores,Cobb angle,mean variation of anterior and middle vertebral body height appeared to have no significant contrast between surgical group and control group before treatment(P>0.05).The VAS scores,ODI scores and Cobb angle were decreased extremely,and the anterior vertebral body height and middle vertebral body height were increased significantly between surgical group and control group in each follow up time(P<0.05).Conclusion:Kyphoplasty is a safe and effective method in the treatment of thoracolumbar osteoporotic vertebral compression fractures,leading to early pain control,restoration of the anterior vertebral body height and middle vertebral body height,rectification of the Cobb angle and gratification with the short-term therapeutic effect.Kyphoplasty is worth popularizing and applying in clinic.PART Ⅱ Kyphoplasty in Treatment of Thoracolumbar Osteoporotic Vertebral Compression Fractures associated with Peripheral Wall DamageObjective:To evaluate the therapeutic effects of kyphoplasty on thoracolumbar osteoporotic vertebral compression fracture associated with damages of the peripheral wall and to evaluate its short-term therapeutic effects.Methods:From August 2012 to August 2014 in our hospital,65 patients(23 males and 42 females,mean age is 71.5 years)with thoracolumbar osteoporotic vertebral compression fracture associated with damages of the peripheral wall were enrolled and cured with kyphoplasty.Mean variation of anterior vertebral body height and middle vertebral body height,Cobb angle,Visual Analog Scale[VAS]scores,Oswestry Disability Index[ODI]scores,and complications were observed and recorded preoperatively,postoperatively,and at 1 month,6 months,and 24 months after treatment.Results:The VAS scores,ODI scores and Cobb angle were decreased significantly,and mean variations of anterior vertebral body height and middle vertebral body height were increased significantly from pre-to post-operation(P<0.05).All above improvement was appeared to have no significant variation from post operation to two-year follow-up(P>0.05).Cement leakages were detected in 7 patients(10 vertebraes),but did not produce severe therapeutic symptom.There was no impairment to spinal nerve roots and no complication of bleeding,infection,stroke,pulmonary embolism,or cardiac cerebral arrest.Conclusion:These outcomes indicate that kyphoplasty is feasible and safe to treat thora-columbar osteoporotic vertebral compression fracture with damages to the peripheral walls,leading to augmentation of the vertebral body height,palliation in pain,rectification of the kyphotic angle and gratification with the short-term therapeutic effect.Part Ⅲ Kyphoplasty in Treatment of Thoracolumbar Osteoporotic Occult Vertebral FracturesObjective:To evaluate the treatment outcomes of kyphoplasty on thoracolumbar osteoporotic occult vertebral fractures and to assess its short-term clinical effect.Methods:From January 2011 to December 2013 in our hospital,eighty-nine patients(55 females and 34 males,mean age=67.5 years)with thoracolumbar osteoporotic occult vertebral fractures were enrolled and treated with kyphoplasty.Mean variation of anterior and middle vertebral body height,Visual Analog Scale[VAS]scores,Oswestry Disability Index[ODI]scores,SF-36 scores and complications were observed and recorded preoperatively,postoperatively,and at 1 month,6 months,and 24 months after treatment.Results:The VAS scores and ODI scores were decreased significantly,and SF-36 scores was increased significantly from pre-to post-operation(P<0.05).The mean variations of anterior and middle vertebral body height were appeared to have no significant changes from pre-to post-operation(P>0.05).These outcomes appeared to have no significant changes from post-operation to 2-year follow-up(P>0.05).Cement leakage was detected in 9 cases(12 vertebraes),but did not cause severe clinical symptoms.There were no injuries to spinal nerve root and no complications of infection,bleeding,pulmonary embolism,stroke,or cardiac cerebral arrest.Conclusion:These findings indicate that kyphoplasty is a safe and effective method in the treatment of thoracolumbar osteoporotic occult vertebral fractures,leading to rapid reduction in pain and satisfaction with the short-term curative effect.