| Fractures which related to osteoporotic have grown as the aging problem is moreand more obvious in recent years, among which thoracic and lumbar vertebralcompression fractures are the most common complications. the traditional treatmentmethods for osteoporotic vertebral compression fracture include bed rest, brace, oralpainkillers, but the effects are not obvious, and long-term bedridden may increase therisk of complications and also lead to further bone loss. Application of pedicle screwsystem fixation,due to operation trauma and bleeding many patients are impossible totolerate the operation and the operation can not restore the compression of trabecularbone, leaving voids in the anterior vertebral column, unable to restore vertebral strengthand stability, in addition, osteoporosis cause pedicle screw anchor difficult to controlforce,this condition may cause internal fixation failure or the failure of operation.Percutaneous kyphoplasty is widely used all over the word and it is a simple andeffective method.Objective: To evaluate the efficacy and related problems of percutaneouskyphoplasty in treatment of osteoporotic vertebral compression fractures.Methods:31patients with fresh osteoporotic vertebral compression fractures(male9cases and female22cases) whose average age was64.2years old(range51to78) were treated with percutaneous kyphoplasty,including T12twelve cases，L1twelvecases，L2six cases，L3four cases.The average time from injury to the operation was5.9d(range1to14days).The most common cause of the disease was falling down anda few patients had no obvious injury history. The back pain was the main symptom,without neurological damage signs; The X-ray, CT examination showed vertebralposterior wall without injury,no compression of the spinal cord. Laboratoryexamination confirmed that there were no obvious operation contraindications.Visual analog scale(VAS)，the use of pain-killer scale，locomotor activity scale，the kyphosiscobb’s angle and the height of vertebral leading edge and midline bodies were evaluatedpreoperative, postoperative2days and the long-term follow-up. The complication wasrecorded simultaneously．Results:29cases were followed up for15.6months (range6months to24months)．The back pain was marked relieved postoperatively．VAS pain seore improvedfrom8.06±0.99preoperatively to1.95±0.97postoperatively two days and2.01±0.95atthe last follow-up(P<0．01)．Locomotor activity scale improved from2.70±0.59preoperatively to1.35±0.49postoperatively two days and1.41±0.50at the last follow-up(P<0．01). The use of pain-killer scale improved from1.48±0.94preoperatively to0.20±0.45postoperatively two days and0.22±0.54at the last follow-up(P<0．01). Themean height of the leading edge vertebral body was from18.61±1.72mm preoperativelyto22.06±1.41mm postoperatively two days and22.02±1.35mm at finalfollow-up(P<0．01)． The mean height of the midline vertebral body was from18.67±1.56mm preoperatively to21.95±1.59mm postoperatively two days and21.51±1.55mm at final follow-up(P<0．01)．The mean kyphosis cobb’s angle wasimproved from (19.35±4.81）°preoperatively to （14.03±2.22）°postoperatively twodays，and （14.10±2.15）°at final follow-up(P<0．01).3vertebral bodies(8.8％)hadcement leakage without adverse events，and neighborhood vertebral compressionfracture occurred in1cases.Conclusion:Percutaneous kyphoplasty can effectively reduce pain caused byosteoporotic vertebral compression fractures, restore vertebral height, increase vertebralstrength, improve the stability of the vertebral body, correct kyphosis, improve thequality of life of the elderly, reduce bone cement leakage rate.So it is a simple andeffective method. |
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