The Clinical Study Between PVP Assistanted By Closed Reduction And PKP In The Treatment Of OVCF

Objective: By comparing the clinical effect and complications between PVP assistanted by closed reduction and PKP, we tried to find which is safe, effective and economical micro-invasive operation to treat osteoporotic vertebral compression fractures. Methods: From October,2008 to April,2010, 25 patients with OVCF in our hospital were involved .They were divided into two groups, group A ,with 14 cases and group B,with 11 cases .The patients in group A accepted PVP assistanted by closed reduction, group B accepted PKP operation. We observed the change of VAS ,Cobb angle, height of anterior border and middle border of veterbral body before and after operation ,together with complications of operation. Furthermore, we compare the difference of results between two groups. Then, we did statistical analyse. Results: 1.The change of VAS score before and after operation in group A was 6.00±0.71, and in group B was 6.10±0.67. There was significant difference before and after operation(P<0.01), but no significant difference between the two groups(P>0.05). 2.In group A, the height of anterior border of veterbral body before and after operation was 15.85±2.39mm and 19.49±2.33mm separately. In group B, the height of anterior border of veterbral body before and after operation was 15.51±3.36mm and 20.15±2.11mm separately. In both groups, there was significant difference before and after operation(P<0.01),but the difference between the two groups was no statistically significant(P>0.05).3. .In group A, the height of middle border of veterbral body before and after operation was 16.81±1.49mm and 20.01±1.45mm separately. In group B, the height of middle border of veterbral body before and after operation was 15.88±1.13mm and 20.60±1.23mm separately. In both groups, there was significant difference before and after operation(P<0.01),and the difference between the two groups was also statistically significant(P<0.05).It shows that the height of middle border of veterbral body in group B was recovered more obviously.4.The change of Cobb angle before and after operation in group A was 10.39°±2.39°, and in group B was 10.43°±2.67°. In both group, there was significant difference(P>0.01), but the difference between the two groups was no statistically significant(P>0.05).5.The incidence of extravertebral cement leakage in group A was 35.71%(5/14),in group B was 9.09%(1/11)。The incidence of extravertebral cement leakage in group A was higher, but the difference between the two groups was no statistically significant(P>0.05). 6. When come to say the incidence of adjacent vertebral fracture, we got the similar result. Conclusion: A satisfactory result in relieving pain, recovering the height of veterbral body partly, and improveing spinal kyphosis could be achieved for those patients with OVCF by using PVP assistanted by closed reduction or PKP with strict indications, carefully operation. The incidence of extravertebral cement leakage and adjacent vertebral fracture was higher in group A, but the difference was no statistically significant. The treatment with PVP assistanted by closed reduction is safe, effective and economical micro-invasive operation to treat OVCF.