The Clinical Observation Of Bone-setting Manipulation Of TCM With PVP Surgery And PKP Surgery On OVCF

Objective The research utilized traditional Chinese medicine bone-setting manipulation combining with percutaneous vertebroplasty (PVP) to reduce compression fracture of vertebral body on osteoporotic vertebral compression fracture (OVCF) with control group of percutaneous kyphoplasty (PKP). We tried to find more evidence for clinical application of this new method on OVCF.Methods From 2003 to March, 2007, 42 inpatients with OVCF in our hospital orthopaedic department were involved. All patients were over fifty and accepted PVP or PKP operation. These patients were divided into two groups, group A and group B. The patients in group A accepted bone-setting manipulation of TCM and PVP operation, group B accepted PKP operation. We observed the change of VAS, Cobb angle, height of anterior border and posterior border of vertebral body, Oswestry score before and after operation, together with complication of operation. Furthermore, we compare the difference of results between two groups.Results1. Pain relief in two groups was both 100%. VAS score decreased after operation, and the difference was significant P＜0.01).The VAS score between the two groups showed no difference (P＞0.05).2. The dose of bone cement in group A was 4.303±1.199ml and in group B was 2. 920±0.777ml. There was significant difference between the two groups(P＜0.01).3. The change of Cobb angle before and after operation in group A was 3.98±4.71°, and in group B is 2.36±3.69°. In both group, there was significantly difference. The spinal kyphosis was improved. The difference between the two groups was no statistically significant.4. In group A, the height of anterior border of vertebral body before and after operation was 0.68±0.15 and 0.80±0.12 separately. In group B,the height of anterior border of vertebral body before and after operation was 0.62±0.17 and 0.74±0.16 separately. In both groups, there was significant difference before and after operation, but the difference between the two groups was no statistically significant.5.In group A,the height of posterior border of vertebral body before and after operation was 0.88±0.09 and 0.92±0.85 separately. In group B,the height of posterior border of vertebral body before and after operation was 0.85±0.10 and 0.89±0.91 separately. In both group, there was significant difference, and the difference between the two groups was statistically significant. It showed that the height of posterior border of vertebral body in group B was recovered more obviously.6. The incidence of extravertebral cement leakage in group A was 27.6%(8/29), in group B is 5.7% (2/35)。Conclusions: PVP with bone-setting manipulation of TCM and PKP on OVCF got satisfactory pain relief, and partly recovered the height of vertebral body, reduced spinal kyphosis. Pain relief, recovery of height of vertebral body, improvement of spinal kyphosis, improvement of quality of life showed no significantly difference between the two groups. Bone-setting manipulation of TCM got good effect on vertebral compression fracture. We concluded Bone-setting manipulation of TCM with PVP operation have fine value on OVCF treatment.