The Analysis Of Related Factors Of Vertebral Enhanced Techniques In Osteoporotic Compression Fracture Of Vertebral Body

Purpose: Osteoporotic vertebral compression fracture in elderlypatient is a long-standing chronic disease, demonstrating as persistent andintractable low back pain and motor function in elderly patient, which canhave a serious impact on daily life and physical and mental health. Thepurpose for OVCF is to relieve pain, restore vertebral compressiondeformity geometry, thus significantly improve motor function in patients.The vertebral body enhancement technology used in clinical is mainly thepercutaneous vertebroplasty and percutaneous kyphoplasty. However, thereare some arguments about the advantages and disadvantages of these twotechniques, the risk factors for the post-operative complication and thepre-operative factors affecting the efficacy of postoperative. Therefore, thispaper summarizes and reviews a large number of samples with statisticalmethods to analyze these pre-operative factors and look for the potential direct or indirect relationships among these factors so as to establish astatistic model for further analysis in clinical.Methods: The study included123patients with osteoporotic bonefractures of vertebral compression. At first, using statistical methodanalyzed the potential relationship between a series of preoperative factors,such as gender, age, surgical techniques, vertebral compression shapes,chronic disease states, injury time, bone density, body mass index andintraoperative compression injury severity and some post-operativeoutcomes of wedge angles,kyphotic angles and the rate of bone cementleakage.Furthermore, according to Genant’s method, we classify compressedvertebrae as mildly deformed (group A),moderately deformed(gourp B)and severely deformed(group C) on the basis of anterior and/orintermediate heights of compressed vertebra in post-anterior X-ray films,and compare whether the two surgical techniques have statisticaldifference about the angle correction and pain relief(VAS) under differentcompression levels.Results: Statistical analysis shows that different surgicaltechniques(percutaneous vertebroplasty and percutaneous kyphoplasty),preoperative bone density wedge angle and the degree of compression is the major and direct factors affecting the wedge angles correction.Different surgical techniques (percutaneous vertebroplasty andpercutaneous kyphoplasty), injury time, bone density and the degree ofvertebral compression is the main direct factors that affect the degree ofkyphosis corrected. In the rate of bone cement leakage, the degree ofpre-operative wedge angle and kyphotic angle directly affect bone cementleakage. Further analysis of the factors shows that the degree of wedgeangle can be affected by bone density, the degree of kyphotic angle can beaffected by Body Mass Index and the Body Mass Index can determine theBone density.The VAS relief has significantly statistical difference betweenpre-operation and post-operation in the two surgical methods. After thesurgery, both of the methods can reduce wedge angle and kyphotic anglestatistically(P<0.05).The comparison between PKP and PVP shows thatPKP is better than PVP in the correction of wedge angle and kyphoticangle(P<0.05).Both of the angles in group A and B don’t have statisticaldifference in PKP and PVP, however, in group C,the wedge and kyphoticangle correction in PKP are better than those in PVP(P<0.05).Conclusion: To our known, this is the first time to comprehensiveanalysis the direct and indirect various factors that influence the geometry of the vertebral body deformity correction, indicating that differenttechniques and the degree of preoperative degree is the main direct factors.However, we should also pay attention to the indirect factors of Bonedensity and Body Mass index, which are also important for the surgicaloutcomes. Both the PKP and PVP can significantly reduce wedge andkyphotic angle and restore physiological curve in spine, also relieve thepain. However, considering that percutaneous vertebroplasty is muchcheaper than percutaneous kyphoplasty, we can choose PVP as thetreatment in mild and moderate compression to reduce the medical expenseof patients.