PKP Joint Manipulation Treatment Of Osteoporotic Thoracolumbar Compression Fractures RCT Study

Purpose:This study use randomized controlled experiment. Compare and study the clinical efficacy of hyperextension traction reduction combined the PKP with simple PKP treatment of Osteoporotic Vertebral Compression Fractures,Summing up the experience of clinical treatment of Osteoporotic Vertebral Compression Fractures.Methods:Analysis32cases of Osteoporotic Vertebral Compression Fractures that come from Teaching Hospital of Chengdu University of TCM in March2012to December2012. Among them the treatment group treatment with hyperextension traction reduction combined the PKP,and the control group treatment only with PKP.Observe patients with the waist back pain VAS score, segmental kyphosis Cobb angle, the height of vertebral body anterior border middle border and posterior border, amount of bone cement injected, follow-up after3months the waist back pain VAS score and the injured vertebra reexamination situation.comprehensive evaluation the Bone-setting Manipulative Reduction of TCM combined with PKP treatment of the clinical efficacy of Osteoporotic Vertebral Compression Fractures.Result:1.The comparison of operative time:the treatment group can shorten the operation time, compared with the control group, the comparison of operation time of the two groups have statistical significance(p<0.05).2. The comparison of amount of bone cement injected:it can increase the amount of polymethylmethacrylate injected that hyperextension traction reduction combined the PKP, compared with the control group, the comparison of bone cement injection amount of the two groups have statistical significance(p<0.05).3. The comparison of2days after surgery the waist back pain VAS score: treatment in both groups could significantly alleviate pain in patients. The comparison of two groups of2days after operation, VAS score have not statistical significance(p>0.05).4.The comparison of postoperative Cobb angle correction in patients with kyphosis, the effect of the treatment group is better than the control group, the comparison of the postoperative Cobb angle of two groups have statistical significance (p<0.05).5. The comparison of the height of postoperative injured vertebra, the anterior border,the middle border and the posterior border:The two groups’ comparison of the anterior border’s height of postoperative injured vertebra have statistical significance(p<0.05),the two groups’ comparison of the middle border’s height of postoperative injured vertebra have statistical significance(p<0.05),the two groups’ comparison of the posterior border’s height of postoperative injured vertebra have statistical significance(p<0.05).6. The comparison of bone cement leakage:the comparison of the two groups of postoperative bone cement leakage have not statistical significance (p>0.05).7. The comparison of VAS score3months after surgery:treatment in both groups could significantly alleviate pain in patients.the comparison of two groups of3months after operation. VAS score have not statistical significance(P>0.05).8. The comparison of Cobb angle3months after surgery:correction in patients with kyphosis,the effect of the treatment group is better than the control group, the comparison of two groups of the Cobb angle3months after surgery have statistical significance(p<0.05).9. the comparison of the injured vertebra’s height3months after surgery, the anterior border the middle border and the posterior border:Three months after surgery the two groups’ comparison of the anterior border’s height of injured vertebra have statistical significance (p<0.05), three months after surgery the two groups’ comparison of the middle border’s height of injured vertebra have statistical significance(p<0.05), three months after surgery the two groups’comparison of the posterior border’s height of injured vertebra have statistical significance(p<0.05).Conclusion:Hyperextension traction reduction combined the PKP has the definite effect to treat Osteoporotic Vertebral Compression Fractures, it can treat the patient’s pain and correct kyphosis, it combines the advantages of Bone-setting Manipulative Reduction of TCM and modern minimally invasive technology, can maximize the recovery of vertebral height, it is able to maximize the recovery of vertebral height, to reduce the operation time to correct kyphosis and maintain the physiological curvature of the spine, etc..It is worthy to be popularized in clinic.