Long-term Follow-up Study Of Percutaneous Vertebroplasty And Kyphoplasty In Treatment Of Osteoporotic Vertebral Compression Fractures

Objective:To understand the epidemiological characteristics of osteoporotic vertebral fracture patients.Comparing PKP(percutaneous kyphoplasty) and PVP (percutaneous vertebroplasty, PVP) in the treatment for osteoporotic vertebral compression fractures clinical results and long-term follow-up results.Methods:A retrospective study was performed on the patients who had undergone PKP and PVP for osteoporotic vertebral compression fractures in Beijing Military General Hospital from October2010to October2012. Statistics basic information of patients, mechanism of injury, duration of disease, hospitalization, fracture segments.A total of61patients with79vertebrals. Age51-90years, average70.3years, male16, female45, male to female ratio of1:3. PKP treated of24patients with26vertebrals, LI vertebral8cases, L2vertebral case, L3vertebrae2cases, L4vertebra1case, T8vertebral1case, T10vertebrae2cases, T11vertebra2cases, T12vertebral8cases,19females,5males, mean age71.4years, average duration8.8d.PVP treatment of37patients with53vertebrals L1vertebral15cases, L2vertebra7cases, L3vertebral4cases, L5vertebra2cases, T6, T7, T10vertebra in1case respectively, T8vertebral t2cases, T11vertebrae2cases, T12vertebra18cases,25females,12males, mean age69.7years, average duration15.5d.Statistics VAS (Visual Analog Score) at before and after operation24hours, measured anterior height of the vertebral at before and after operation, operation progress, bone cement leaking.the follow-up of patients with VAS score, vertebral height, vertebral (including the adjacent vertebral) fractures, and anti-osteoporosis treatment.Results:Injury mechanism of osteoporotic vertebral compression fractures is low-energy injury, short duration, focused on patients ages70-80years old, fracture segment focused on the T12, LI. Amount of bone cement PKP group (4.46±1.51) ml, PVP group (4.00±1.34), two bone cement injection volume was T-test P>0.05, there was not statistically significant difference.preoperative and postoperative VAS scores were statistically significant (P<0.05) in PKP and PVP. Postoperative VAS no significant difference (P>0.05) between PKP and PVP. The vertebral height restoration were statistically significant (P<0.05) between PKP and PVP, PKP group was significantly higher than PVP group (P<0.05) postoperative. There was no statistically significant difference (P>0.05) bone cement leakage rate.Follow-up results PKP group16people for12-36months, average follow-up time (22.6±8.6) months, PVP group were followed26people for12-36months, average follow-up time (21.8±7.9) months, two follow-up time T-test P>0.05, there was no significant difference between the two groups.Follow-up VAS score PKP group1.13±1.26, PVP group0.96±1.18, T-test showed a statistically significant P>0.05. Vertebral PKP18, PVP38. PKP group lost an average height (1.89±0.71) mm. PVP group lost an average height (0.74±0.55) mm. T-test showed a statistically significant P<0.05. Long-term follow-up of both groups vertebral height loss. PKP group lost vertebral height greater than PVP group, anti-osteoporosis treatment30cases, intermittent treatment for6cases, not anti-osteoporosis treatment6cases, the treatment rate was86%. vertebral fracture in7cases, PKP group3cases, adjacent vertebral fractures2cases. PVP group4cases, adjacent vertebral fractures lease.Conclusion:Osteoporotic vertebral compression fractures of low-energy injuries, focused on T12、L1segment. Most of patients with internal diseases to increase hospitalization time.PKP and PVP in treatment for osteoporotic vertebral compression fractures had ideal clinical effects, pain relief was significantly effective, there was no difference between both groups.PKP is better than PVP in the vertebral height restoration. Two groups no significant difference in bone cement leaking, Long-term follow-up of both pain relief is stability. Both groups losed vertebral height, PKP significantly higher than PVP.