Clinical Contrast Research Of Osteoporotic Vertebral Compression Fracture Treated With Traditional Chinese Medicine Combined Therapy And PKP

Objective:To compare the efficacy of percutaneous kyphoplasty (PKP) with Traditional Chinese medicine combined therapy for patients with osteoporotic vertebral compression fractures.Methods:Patients were recruited to this trial from the Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine between June2012and June2013. Patients were aged50years or older, had osteoporotic vertebral compression fractures on spine radiograph. Changes in pain intensity (Visual Analogue Score), physical functioning(Oswestry Score), Cobb angle and the height of anterior border and posterior border of vertebral body were evaluated. The treatment results of two groups were statistical analysed and complications were recorded randomly.Results:we identified70patients (7men and63women, age50～102) who were eligible for this study. Thirty-three patients received PKP, whereas37received Traditional Chinese medicine combined therapy.Both PKP and Traditional Chinese medicine combined therapy provided pain reduction(P<0.001), improvements in physical functioning(P<0.001), and the height of anterior border and posterior border of vertebral body(P<0.05), and decreased Cobb angle (P<0.05). Reductions in visual analogue pain scores were more significant in the PKP group at1weeks after treatment (P<0.001), but not at3months and6months (P>0.05). Improvements in physical functioning were significant at1weeks (P<0.05), but not at3months and6months (P>0.05). Improvements in the height of anterior border and posterior border of vertebral body and the Cobb angle were significant in the two groups at1weeks after treatment (P<0.05). But there were not significant in the Traditional Chinese medicine combined therapy group at6months (P>0.05). Total costs of the Traditional Chinese medicine combined therapy group were much less than the PKP group.Bone cement leakage was notes in3patients(9.1%) from the PKP groups. Symptomatic re-fractures were noted in nine patients. Six PKP patients (18.2%) had re-fractures within6months. Only2patient(5.4%) in the Traditional Chinese medicine combined therapy group had symptomatic re-fracture and was treated medically. This amounted to a nonsignificant trend(P=0.094) toward a higher re-fracture rate in the PV group. Half (3/6) of new vertebral compression fractures were adjacent to a level initially treated with PKP.Conclusion:Both Traditional Chinese medicine combined therapy and PKP are reliable treatments in OVCF, which can relieve the clinical symptoms and improve the quality of life. Pain relief, physical functioning improvement after PKP are immediately and significantly better when compared with conservative therapy. But there are no difference betweet the two methods from3months later. Traditional Chinese medicine combined therapy is very simple and effective but also cheap. There is a certain risk and high cost of PKP, which may also increase the incidence of new fractures. When the patient affordability limited capacity, combined treatment of traditional Chinese medicine may be as a priority.