| Background:World Health Organization (WHO) statistics shows that, at pres-ent, the total number of patients with osteoporosis has been over200million people worldwide, Which only the United States, Western Europe and Japan there is over7500million, osteoporosis is recog-nized as the second largest killer after cardiovascular disease. The control situation is grim in osteoporosis disease prevention and cure in China. Osteoporosis patients who were older than60years old, the crowd incidence was56%, with women rates as high as60%to70%. Osteoporotic vertebral compression fractures (OVCF) was a common complication, increasing attention has been paid. And for the osteoporotic vertebral compression fracture’s treatment has the minimally invasive surgical treatment and conservative treat-ment. The conservative treatment is often used bed rest parallel to the anti-osteoporosis, pain treatment. the pain stimulation easily aggravate existing heart and lung and other medical disor-ders when patient do functional exercises, for some patients conservative treatment is poor. Minimally invasive treatment of osteoporotic vertebral compression fractures is precisely to solve the defici-encies of the traditional treatment, early treatment can relieve pain quickly. The early functional exercise can prevent the bedri-dden complications occurred, some clinical cases, conservative therapy can also obtain good effect for them, the key is to master their own indications and contraindications. The study concluded that the clinical effect of two therapeutic methods and compare.Objective:The aim of this article is to investigate the vertebroplasty and conservative treatment of osteoporotic vertebral compression fractures of the clinical efficacy, and indications of their resp-ective advantages and disadvantages.Methods:The clinical information of81patients was gathered in Hubei Provincial Hospital of TCM from June1,2007to Dec1,2011, including PVP surgery in38cases, conservative treatment in43cases,34cases of male,47cases of female, all cases age from47to83years old(average65years old). All patients are checked by the x-ray confirmed, physical examination and imaging were not symptoms of spinal cord and nerve root compression, rule out other pathology caused by vertebral compression fractures. Cases of surgical group:minimum60years of age, up to83years, an average of68. Course of less than or equal to1week32cases, greater than1week6is less than2weeks. Vertebral involvement T128cases, L124cases, L26case, involving2or more than2vertebral4cases, a total of38cases of44compressed vertebrae.38cases,18cases of hypertension,26cases of heart disease, urinary tract disease12cases,10cases of lung disease.16of these cases and explain the disease and treatment plan initiated after surgery and22cases in relation to their body, doctors recommend surgery for patients and their family members have expressed consent. Preoperative posterior border of three dimensional reconstruction of CT test to determine the risk of vertebral integrity. Involvement of vertebral body compression height is less than half of the vertebral body. Conservative Group case:minimum of47years of age, maximum80years and63years on average.38cases of course less than or equal to1,5cases of greater than1week is less than2. Vertebral involvement T124, L128, L211, are a single vertebral compression. In43cases,20cases of hypertension, remaining no obvious medical diseases, and explain the disease and treatment options, select conservative treatment, and expressed its willingness to cooperate with functional exercise.81cases’follow-up were available, and according to VAS pain score, Cobb angles and vertebral body height loss rate evaluation.Result:On the analgesic effect, set before and after operation compar-ison after the1th day,1week, January and March, differences were statistically significant (p<0.01). Conservative group before treatment and after treatment, respectively1week, January, March, differences were statistically significant (P<0.01). Comparison of two groups before treatment, the difference was not statistically significant (P>0.05).There were no vertebral compression fracture occurs adjacent vertebral fractures. Surgery group,3cases of bone cement leakage, but no obvious clinical symptoms of nerve compression, etc., with-out making special treatment.1case of the conservative group did not complications. Vertebroplasty and conservative treatment in both treatment groups achieved satisfactory results.1week after treatment with difference statistically significant (P<0.01), after treatment last one month the difference was not statistically significant (P>0.05), after treatment last three month the differ-ence was not statistically significant (P>0.05), the pain of pat-ients get significant mitigation by pvp surgery after1day, lweek. It was indicate surgical group superior to the conservative group after one week.Two groups of VAS pain score in patients was no obvious difference after one and three month. One month compared with before by PVP surgery, Cobb angles and changes of vertebral body height lost a significant difference (P<0.01), two groups after surgery may reduce the Cobb angle, the difference was which vertebral height was restored and the Cobb angle was reduced by operating, but conservative group could be restored only after one month. None of the two groups of adjacent vertebral body occurred vertebral body fracture. Surgery set of3cases with bone cement leakage occured, but without obvious clinical symptoms of nerve compression and spinal cord injuryed, without special treatment. Conservative Group didn’t occur one cases of complications. Conse-rvative therapy and PVP surgery were satisfactory.Conclutions:For patients with osteoporotic vertebral compression fractures, selection of PVP or conservative treatment, to make a choice depen-ding on the patients after a comprehensive assessment of the situ-ation, besides age and general condition of the patient was an evaluation of the main content.Two methods of adapting to their patients with good efficacy, and PVP was remarkable effective in the early procedure, however, there was no significant difference between the two methods after one months. Strictly adhere to the respective indications of PVP and conservative treatment, so that the two methods to better serve the clinical. |
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