| Objective The purpose of this study was to evaluate percutaneous vertebroplasty(PVP) treatment for Chronic osteoporotic vertebral fractures. Clinical and radiological results were evaluated based on the Visual Analogue Scale (VAS),the Oswestry Disability Index (ODI),the kyphotic angle according to Cobb and kyphotic angle.Methods From June1,2010to September1,2011,Author myself collected Chronic OVCF patient data a total of41(22women,19men; mean age,67.3years; range,60-83years) cases in the second hospital of tangshan (hebei united university orthopaedic hospital affiliated, hebei province).All patients were suffering from lumbar back pain at least3weeks (3-12weeks),and followed up for at least12months (12-18months).All patients with preoperative history of thoracic lumbar back intractable pain, limited daily activities, X-ray, CT and MRI examination after confirmed for single segmental pulmonary OVCF. vertebral fracture:T11in3cases, T12in10cases, L1in17cases,9cases were L2, L3in2cases. Through preoperative and postoperative3days,3months, visual analogue scale (VAS score) in December, Oswestry Disability Index (Oswestry Disability Index, ODI), the kyphotic angle according to Cobb and kyphotic angle after PVP clinical curative effect. All patients were treated with percutaneous puncture vertebroplasty, smooth operation, postoperative close observation patient’s vital signs and the activity of lower limbs, the treatment such as to prevent infection. Patients with postoperative1day in bed, bed on the second day after surgery. Postoperative conventional X-ray and CT examination, review on a regular basis. Statistics and measurement after3days,3months and12months after VAS score, ODI index,the kyphotic angle according to Cobb and kyphotic angle.Results All patients were followed up.Patients with postoperative instructed to turn, lower back pain than preoperative significantly reduce.After PVP back pain symptoms in patients with ease, VAS score significantly reduced.The preoperative VAS score was (7.6±0.7),After3days,3months and12months,the VAS score were (2.3±0.5),(2.2±0.4),(2.1±0.3),Compared with the preoperative difference had statistical significance(P<0.05).Postoperative ODI score also significantly lower.The preoperative ODI score was (73.6±7.3)%,After3days,3months and12months,the ODI score were (26.5±4.7)%,(25.5±3.9)%,(24.4±3.1)%,Compared with the preoperative difference had statistical significance (P<0.05).After postoperative the kyphotic angle according to Cobb has no obvious improvement. The preoperative the kyphotic angle according to Cobb was (12.2±1.0)°,After3days,3months and12months,the the kyphotic angle according to Cobb were (12.2±1.0)°,(12.3±1.0)°,(12.3±1.0)°,Compared with the preoperative difference had statistical significance(P<0.05).After postoperative the kyphotic angle has no obvious improvement.The preoperative the kyphotic angle was (10.1±0.4)°,After3days,3months and12months,the the kyphotic angle were (10.1±0.4)°,(10.1±0.4)(10.2±0.4)°,Compared with the preoperative difference had statistical significance (P<0.05).Postoperative CT examination found in5cases of bone cement leakage incident, but had no clinical symptoms, including1case of vertebral side leakage of blood vessels,4cases for fanterior flange leakage, leakage rate was12.2%(5/41).Conclusion For chronic osteoporosis vertebral compression fractures, as a kind of micro invasive percutaneous vertebroplasty surgery, is a safe and effective treatment, the pain relief, stability, exercise capacity improvement is significant in terms of the vertebral bodies. Compared with conservative treatment, vertebroplasty can greatly shorten the patient bed time, and small surgical trauma, fewer complications, avoid the conservative treatment of vertebral height loss, stay in bed for a long time, such problems as low back pain, had a higher clinical value. So, to have a low back pain for a long time, confirmed by imaging for old fracture patients, without surgical contraindications, should accept the vertebroplasty as early as possible. Percutaneous vertebroplasty in the convex Cobb Angle, lobe after recovery is not obvious. In this study, the follow-up period, there was no new fractures, due to the number of cases of this study is less, the follow-up time is shorter, so it cannot be ruled out after PVP increase the risk of new fracture in vertebral. |
