Association Of Vertebral Height Restoration In Osteoporotic Vertebral Compression Fractures With Clinical Results

Objective To assess the early results and safety of vertebroplasty, kyphoplasty and conservative therapy for the treatment of osteoporotic vertebral compression fractures with the pain score of numeric rating scale and loss rate of vertebral height.Methods Retrieval data of the patients who have a treatment of osteoporotic compression fractures in the department of orthopedics of the First Affiliated Hospital of GuangZhou University of Chinese Medicine. All patients were divided into three groups, group A(PVP),group B(PKP), group C(conservative therapy);20 patients in each group. To analyze the clinical effect according to the assessment scale proposed by Visual analogue scales(VAS),Oswsetry Disability Indexs (ODI),and radiographic. Investigatings were learned by statistics. Something was down to compare the improvement rate of the patients and radiographic with different follow-up group, at the same time, analyzing association of the lost rate of anterior of vertebral body and the pain grade of VAS,analyzing association of the recovery rate of anterior portion of vertebral body and the improvement of the pain grade of VAS.Results 1. In the group A and B, there was statistical difference between the pre-operative and post-operative of the height of anterior and middle portion of the vertebral body (P<0.01), there was no statistical difference between the post-operative and last follow-up of the height of anterior and middle portion of the vertebral body(P>0.05), there was no statistical difference between the group A and the group B(P>0.05); In the group C, there was statistical difference between the pre-operative and post-operative of the height of anterior and middle portion of the vertebral body (P<0.05), there was no statistical difference between the post-operative and last follow-up of the height of anterior and middle portion of the vertebral body(P>0.05), there was statistical difference among the group C and the group A or B(P>0.05).2. In the group A and B, there was statistical difference between the pre-operative and post-operative of the scores of VAS and ODI (P<0.01), here was no statistical difference between the post-operative and last follow-up of the scores of VAS and ODI (P>0.05), there was no statistical difference between the group A and the group B; In the group C, there was statistical difference between the pre-operative and post-operative of the scores of VAS and ODI (P<0.05), here was statistical difference between the post-operative and last follow-up of the scores of VAS and ODI (P<0.05), there was statistical difference at post-operative between the group C and the group A or B(P<0.05),there was no statistical difference at the last follow-up between the group C and the group A or B(P>0.05).3. The lost rate of anterior portion of vertebral body were associated with the pain grade of VAS. There was no correlation between vertebral body height recovered rate and improvement of VAS.4. In the group C, the scores of conservative therapy was degraded, and the effective power was 85%.5. In the group A, there were 4 cases of bone cement leakage in the operation, and 2cases in the group B; 4 cases of refracture of vertebral bodies at last follow-up. In the group C, there were 2cases of pulmonary infection and 2 cases of bed-sore during the convalescent period. Conclution 1. Percutaneous vertebroplasty, percutaneous kyphoplasty and conservative therapy are safe and effective in treatment;2. In the short intermediate follow-up, The clinical curative effect of percutaneous vertebroplasty and percutaneous kyphoplasty is better than conservative therapy.3. Prcutaneous vertebroplasty and percutaneous kyphoplasty not only can provide early pain relief and enhance vertebral body rapidly to improve the function rapidly and reduce the complication,but also provide effective vertebral height restoration and improve kyphosis to revert the spine series and delay the degeneration.4. Conservative therapy is a safe and effective technique in treatment. It comparison with the percutaneous vertebroplasty and the percutaneous kyphoplasty, has longer pain relief and higher Incidence of the complication, especially for the elder patients, but the result of pain relief at last are the same. It still a reliable choice for the patients who are not treated surgically.