A Comparative Study Of Cushion Pillow Therapy Vesrs PKP In Osteoporotic Vertebral Compression Fractures

1 ObjectiveTo compare the medium-to-short term efficacy of cushion pillow therapy with percutaneous kyphoplasty(PKP) for patients with osteoporotic vertebral compression fractures, and indicate the advantages and disadvantages of these two trentments.2 MethodsThis clinical research gathered 72 patients in Anhui Provincial Hospital of TCM from October, 2013 to Mar, 2015,including cushion pillow therapy in 32 cases, PKP surgery in 40 cases, 28 cases of male, 44 cases of female. The clinical date of the two groups were retrospectively analyzed for the comparation of the medium-to-short efficacy of cushion pillow therapy with percutaneous kyphoplasty(PKP) for patients with osteoporotic vertebral compression fractures. All of the patients were evaluated by VAS(Visual analogue scales, VAS) scale,ODI(Oswestry disability index, ODI) scale, the concave of the fanterior flange height and Cobb angle which were measured through a standard lateral X-ray of compression vertebral body before treatment and following visiting, recording these clinical indexes 1d before treatment and after trentment in 1 months, 3 months, 6 months, 12 months. The treatment results of OVCF with two groups were statistical analysed, complications of each methods were carefully noted down.3 ResultsAll patients of PKP group and Cushion pillow therapy group were follow up. The statistical indexs of two groups before treatment were no significant difference(P>0.05). The VAS score of PKP group was improved than pre-opreration in 1 month,3 months,6months and 12 months after trentment(P<0.05), but there is no significant difference between them(P>0.05). The VAS score of Cushion pillow therapy were no significant difference in 1 month and 3 months,6 months and 12 months, but the two groups were significant difference than1 day before trentment. The ODI score changed as the same as VAS score. The ODI score of PKP group was improved than pre-opreration in 1 month,3 months,6 months and 12 months after trentment(P<0.05), but there is no significant difference between them(P>0.05). The ODI score of Cushion pillow therapy were no significant difference in 1 month and 3 months,6 months and 12 months, but the two groups were significant difference than1 day before trentment in ODI score. The concave of the fanterior flange height and Cobb angle of PKP group were improved than pre-opreration in 1 month,3 months,6 months and 12 months after trentment(P<0.05). The concave of the fanterior flange height and Cobb angle of Cushion pillow therapy group was higher than the PKP group, and these two indexs of PKP group and Cushion pillow therapy group were significant difference(P<0.01). Three cases of PKP group had occured the leakage of bone cement, but there was no significant nerve compression, spinal cord injury, the incidence was 7.5%. New fractures occurred in 3 cases(4vertebrae) with PKP, in 1 cases with Cushion pillow therapy.4 ConclusionFor the treatment of patients with osteoporotic vertebral compression fractures, The Cushion pillow therapy and Percutaneous Kyphoplasty have no significant difference in the medium term effect. Both of the two treatments can alleviate symptoms of patients with lumbar back pain effectively and improve the function of limb. The analgesic effect of PKP holds fast, the stabilization of vertebral body and the reconstruction of vertebral height are effectively. but there is still a certain risk of leakage of bone cement, and PKP may increased the incidence of adjacent vertebral fractures. Meanwhile, Cushion pillow therapy is simple for operation and significant effect for pain relief, but the defect of Cushion pillow therapy is also evident, for example, slightly longer duration, and slowness fo pain relef slowly. In view of the above mentioned facts, clinicians should grasp the indications of advantages and disadvantages of Cushion pillow therapy and Percutaneous Kyphoplasty strictly in order to better applied to clinic.