| Objective: Major objective: To analyze and evaluate recent therapeutic effects ofkyphoplasty for different grades of senile thoracolumbar vertebralcompression fractures.Secondary objective: To evaluate advantages of minimally invasivekyphoplasty treatment of compression fracture of senile thoracolumbarvertebrae, and superior effect of clinical symptom rapidly improved aftersurgery.Methods: Collect 20 cases (24 fractured vertebraes) of compression fracture of senilethoracolumbar vertebrae which were orthopedic inpatients of Jiangsuprovincial hospital of traditional Chinese medicine, which affiliated toNanjing University of traditional Chinese medicine. According to imagingmanifestations, all the cases were divided into light、moderate and seriousgroups. Under the monitor of "C" arm X-ray machine, all the cases (20fractured vertebrae) were cured by percutaneous kyphoplasty. Individualizedsurgery and injection quantity of bone cement were applied to differentindividual patients and different grades of compression fracture. When thevertebral walls, especially posterior wall and lateral wall were damaged, bonecement was injected under continuous dynamic supervision of "C" arm X-raymachine, as to avoid cement leakage and other complications as possible.X-ray examinations after surgery were taken to observe the distribution ofbone cement in the vertebrae, the height of vertebral bodies, Cobb angles ofkyphosis and replacement of fracture. We observed whether symptoms andfunction were improved after surgery, and several acute complicationshappened. Then we statistical analysis these related indexes, such as painimprovement、the height of vertebral bodies recovery、changes of Cobb anglesof kyphosis.Results: All of the operations were Carried out successfully, no one had significantcement leakage and related severe complications. The average height of theanterior and middle aspect of the fractured vertebrae before operationwere18.48mm and 18.57mm, while after surgery was 25.04mm and 24.36mm. There were significant differences between pre-operation and post-operation(P＜0.001). The average recovered height of the anterior and middle aspectof all vertebrae after operation were 6.56mm and 5.795mm.They were 5.14±1.36(light group), 6.91±2.12(moderate groups) and 9.15±2.47 (seriousgroup) of the anterior aspect of vertebrae post-operation. Among the threegroups, the serious group had the maximum vertebral height restoration. Thedifference between light and moderate group, as between moderate andserious group, was no statistically significant (P＞0.05). While it hassignificance in statistics between light and serious group (P＜0.05). Theaverage recovered height of middle vertebral aspect after operation were 4.59±1.48 (light group), 6.44±2.26 (moderate group), 7.38±3.11(serious group).The differences among them were no statistically significant (P＞0.05). Theaverage corrective Cobb’s angle of kyphosis was 6.9°, the serious group isthe maximum one(12.75±7.80°). The difference ofΔCobb angle betweenlight and moderate group was no statistically significant (P＞0.05), but theyhad statistically significance from serious group (P＜0.05). Pain wereobviously relieved or disappeared after treatment. Recent average scores ofvisual analog scale for pain and pain scoring messurement were 8.99 and 8.25on the 1st day after admission, while after surgery they were 4.36 and 2.95 in0-8 hour, and the 7th day after surgery were 1.29 and 0.45. Every group itselfhad statistically significance or great statistically significance (P＜0.05, 0.01or 0.001).Conclusion: Percutaneous kyphoplasty for compression fracture of senile thoracolumbarvertebrae is safe and effective, its recent curative effect is exact andsatisfactory, which is considered to be the first preferable and ideal treatmentof vertebral compression fractures. From my study, there are some differencesof alleviating pain between serious grade and other groups. Also there aredifferences of height restoration and Cobb’s angle improvement betweenthem. |
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