A Clinical Study Of Acupuncture Combined With PKP In The Treatment Of Osteoporotic Vertebral Compression Fractures

Objective:To compare the clinical curative effect of the acupuncture combined with percutaneous kyphoplasty(PKP) and PKP alone in the treatment of Osteoporotic vertebral compression fractures.To explain the superiority of acupuncture combined with PKP in the treatment of osteoporotic compression fractures. Providing a theoretical basis for the selection of the most appropriate treatment for osteoporotic vertebral compression fracture.Methods : we have selected 62 patients who were diagnosed osteoporotic vertebral compression fractures from Orthopedics of Hubei Provincial Hospital since March 2013 to October 2014. 17 cases of them were Male and 45 cases of them were female,age 63~85, mean 74.The injured vertebrae were Concentrated in T11~L4.7 cases of T11,24 cases of T12, 20 cases of L1, 8 cases of L2, 1 case of L3, 2 cases of L4. According to the patient’s condition and requirements,they were divided into two groups: ①The control group :32 cases of patients were given the treatment of percutaneous kyphoplasty only.②The treatment group:30 cases of patients were given the treatment of acupuncture combined with PKP.Acupuncture therapy was given after the PKP and choosing different points according to the early postoperative period, mid postoperative period, late postoperative period.Improving the preoperative relevant examination. Assessing surgical risk and the surgery of two groups were carried out by the same group of doctors.Two groups were both given postoperative conventional treatment,anti- osteoporosis therapy and rehabilitation guidance. Then all the patients were followed up postoperatively, and at 3 days, 1, 3, and 6 months after surgery. The Visual Analog Scale(VAS) score was used to evaluate back pain, Oswestry Disability Index(ODI) was used as a functional assessment, and Short Form-36 General Health Survey(SF-36) was used to evaluate the quality of life. Any clinical complications were recorded immediately after the procedure. we compared the clinical result of the two groups with VAS, ODI,SF-36,BMD,cobb angle and bone cement push amount and Vertebral height loss rate.Then we made a statistical analysis. To investigate the Superiority of acupuncture combined with PKP in the treatment of the Osteoporotic vertebral compression fractures.Result: Before the treatment,there were no significant difference between treatment group and control group(eg:age,sex,injured vertebrals,VAS,ODI,vertebral height loss rate,cobb angle)(p﹥0.05). The VAS after the patients were given pkp 3 days later and the Oswestry-function index(ODI) after the patients were given pkp one month later were Decreased significantly which illustrated the effect of PKP surgery on relieving pain and ameliorating dysfunction rapid and significant. The VAS and Oswestry-function index(ODI) were no significant difference between the two groups for 1 month post operative,while the VAS in treatment group were decreased significantly than the control group on both 3 and 6 month postoperatively and the score of SF-36 on physical function, bodily pain, general health, vitality,social function were increased significantly than the control group which illustrated acupuncture combined with PKP had positive effect on pain management and improving quality of life for long-range. 3 month Postoperatively, Both control group and treatment group had no significant difference on BMD when compared with Preoperative.The two groups were failed to treat osteoporosis effectively in the short time. The BMD in two groups were increased until 6 month post operative,which may related with Anti-osteoporosis therapy.The index of BMD in treatment group is higher than control group, which revealed acupuncture combined with PKP played a role on Long-term treatment of osteoporosis. The Cobb angle and vertebral height loss rate of both control group and treatment group decreased significantly when compared with the index of Preoperative. But no significant difference between the two groups. Acupuncture may make no sense on changes of Image.Conclusion: PKP surgery has an effect on relieving pain and ameliorating dysfunction rapid and significant. The treatment of acupuncture combined with PKP has a better effect on pain management and improving quality of Life for Long-term than pkp only,but has no effect on cobb angle and vertebral height loss rate.