Clinical Study On The Treatment Of Bone-setting Manipulative Reduction Of TCM Combined With Percutaneous Vertebroplasty And SKY Expander System For Kyphosis On Osteoporotic Vertebral Compression Fractures

Objective:Research And Comparison in curative effects and Application Prospects of Osteoporotic Vertebral Compression Fractures with bone-setting manipulative reduction of TCM combined with Percutaneous Vertebroplasty and SKY expander system for kyphosisMaterials and methods:A retrospective study was conducted to analysis the inpatients with OVCF in HUBEI Provincial Hospital of Chinese Medicine Orthopedic department and Wuhan General Hospital of Guangzhou Military Area Command of Chinese PLA Orthopedic department from Jun,2007 to Jan,2010.35 female and 20 male,range from 54 years to 91 years(average 72.7 years).History of illness from 2 to 10 days.These patients were divided into two groups, traditional Chinese and western medicine therapy group (TCM WM group)and SKY surgery group. The patients in TCM WM group accepted bone-setting manipulation of TCM and PVP operation,SKY surgery group accepted SKY operation. We Analysis and compare the change of Cobb angle,height of anterior border,middle border and posterior border of vertebral body, VAS score,Oswestry score,operation time,Total dose of bone cemet injected, extravertebral cement leakage at different time point,including pre-operative,48 hours and one month after operation.Results:1.the height of anterior border of vertebral bodyIn TCM WM group,pre-operative was 17.36±3.02mm,48 hours after operation was 20.47±4.21mm,1 month after operation was 20.41±4.22mm,there was significant difference between pre-operative and 48 hours after operation(p<0.01).However,there was no striking difference between 48 hours and 1 month after operation(p>0.05).SKY surgery group, pre-operative was 17.46±3.03mm,48 hours after operation was 19.95±3.93mm,1 month after operation was 19.37±5.12mm,there was significant difference between pre-operative and 48 hours after operation(p<0.05).However,there was no striking difference between 48 hours and 1 month after operation(p>0.05).There was no striking difference between two group (p>0.05).2.the height of middle border of vertebral bodyIn TCM WM group,pre-operative was 20.41±4.22mm,48 hours after operation was 22.02±4.35mm,1 month after operation was 21.99±4.27mm,there was significant difference between pre-operative and 48 hours after operation (p<0.01).However,there was no striking difference between 48 hours and 1 month after operation (p>0.05).SKY surgery group, pre-operative was 19.95±3.93mm,48 hours after operation was 21.61±4.16mm,1 month after operation was 21.58±4.06mm,there was significant difference between pre-operative and 48 hours after operation(p<0.01).However, there was no striking difference between 48 hours and 1 month after operation(p>0.05).There was no striking difference between two group (p>0.05).3. the height of posterior border of vertebral bodyIn TCM WM group,pre-operative was 21.98±4.27mm,48 hours after operation was 22.00±4.26mm,1 month after operation was 21.99±4.25mm,there was no striking difference between pre-operative and 48 hours after operation(p>0.05).However,there was no striking difference between 48 hours and 1 month after operation (p>0.05).SKY surgery group, pre-operative was 21.57±4.07mm,48 hours after operation was 21.58±4.05mm,1 month after operation was 21.57±4.06mm,there was no striking difference between pre-operative and 48 hours after operation(p>0.05).However,there was no striking difference between 48 hours and 1 month after operation(p>0.05).4.the average kyphotic degreesIn TCM WM group,pre-operative was 16.36±4.05°,48 hours after operation was 13.52±2.75°,1 month after operation was 13.57±2.71°,there was significant difference between pre-operative and 48 hours after operation(p<0.01).However,there was no striking difference between 48 hours and 1 month after operation(p>0.05).SKY surgery group, pre-operative was 15.89±3.72°,48 hours after operation was 13.63±2.73°,1 month after operation was 13.65±2.72°,there was significant difference between pre-operative and 48 hours after operation (p<0.05).However,there was no striking difference between 48 hours and 1 month after operation(p>0.05).There was no striking difference between two group (p>0.05).5.level of pain relief In TCM WM group,pre-operative was 7.73±1.35,48 hours after operation was 3.12±1.49,1 month after operation was 3.03±1.48,there was significant difference between pre-operative and 48 hours after operation(p<0.01).However,there was no striking difference between 48 hours and 1 month after operation(p>0.05).SKY surgery group, pre-operative was 7.63±1.43,48 hours after operation was 2.33±0.99,1 month after operation was 2.10±0.19,there was significant difference between pre-operative and 48 hours after operation(p<0.01).However,there was no striking difference between 48 hours and 1 month after operation(p>0.05).There was no striking difference between two group (p>0.05).6.Oswestry disability indexIn TCM WM group,post-operative scores was 11.52±1.49,In SKY surgery group,post-operative scores was 11.27±1.98,There was no striking difference between two group (p>0.05).7.operation timeIn TCM WM group,operation time was 50.82±6.17 min, In SKY surgery group,operation time was 60.93±5.65min, There was significant difference between two group(p<0.01).TCM WM group's operation in a relatively short time.8.Total dose of bone cemet injectedIn TCM WM group,Total dose of bone cemet injected was 2.96±0.92ml,In SKY surgery group,Total dose of bone cemet injected was 3.79±0.98ml,There was significant difference between two group(p<0.01).TCM WM group little dosage of dose of bone cemet injected.9.extravertebral cement leakage The incidence of extravertebral cement leakage in TCM WM group was 9.09%(3/33),in SKY surgery group is 3.33%(1/30)。Conclusions:Bone-setting manipulative reduction of TCM for Osteoporotic Vertebral Compression Fractures effect is obvious.Percutaneous Vertebroplasty and SKY expander system for kyphosis was Minimally invasive technology of vertebral column. They have being the unmatch ascendancy compares to traditional method. Two groups of treatment got satisfactory pain relief,and partly recovered the height of vertebral body,reduced spinal kyphosis,partly or completely recovered functional of daily life.They are proved to have the advantages of shorter treatment course,slighter surgery wound,better curative effect,fewer complications.They can be the first choice of in treatment of Osteoporotic Vertebral Compression Fractures,which is worth to popularize in clinic.