| BackgroundIn recent years,with the increasing population aging in China,osteoporosis patients continue to increase,the occurrence of osteoporotic fractures continue to increase,osteoporotic vertebral compression fractures(OVCFs)is the main type of osteoporotic fractures.Due to the thoracic and lumbar junctions of the force mechanism and morphological characteristics,OVCFs occur in the T11-L2 vertebral body.The incidence of OVCFs is also rising.Conservative treatment in patients with this disease recovers slowly.Lower back pain cannot be timely and effective relief.And some patients with chronic diseases such as cardiovascular disease,diabetes,long-term lie in bed would bring a variety of serious complications.Percutaneous vertebroplasty(PVP)and percutaneous kyphoplasty(PKP)are main operation method to treat clinical thoracolumbar osteoporotic compression fracture.But PVP operation cannot recover compression vertebral body height so as to eliminate the spinal deformity.So there is still a spine biomechanics changes.And bone cement(Polymethylmethacrylate,PMMA)leakage rate is larger in PVP surgery.So PKP has become the current treatment of the disease.Objective Statistics of the protruding after percutaneous kyphoplasty for treatment ofthoracolumbar osteoporotic compression fractures in patients with bone cement usage,length of hospital stay,postoperative anesthesia and surgery time,compare the preoperative degree of postoperative patients with clinical symptoms improve,with changes in vertebral imaging,surgical complications,etc.,to explore the clinical curative effect and the advantages and disadvantages..MethodsChoose our orthopaedic trauma from January 2015 to December 2016 with protruding after percutaneous kyphoplasty during treatment of thoracolumbar osteoporotic compression fracture cases 43 cases,and were retrospectively analyzed.Including 6 cases of male,37 cases of female,aged between 61-84 years old.Dealt with 58 vertebral fracture surgery,including a total of 1 thoracic vertebral(T10),3 T11,14 T12,a total of 18 lumbar vertebral body 1(L1),15 L2,3 L3,4 L4.All patients admitted to hospital after X-ray,CT,MRI and bone mineral density measurement diagnosis of auxiliary examination,related to specific diagnosis of osteoporotic vertebral compression fractures,parallel electrocardiogram,liver and kidney function,blood coagulation function,brain MRI,the chest CT and relevant auxiliary examination,ruled out after surgery contraindications to suffer under local anesthesia of the protruding after percutaneous kyphoplasty,postoperative stay in bed for 12 to 36 hours,while giving analgesia,anti osteoporosis and other symptomatic treatment,all above activities within three days after surgery.Collect all patients with clinical and imaging data,through the observation of anesthesia and operation time,postoperative hospital stay,a single vertebral body bone cement usage,postoperative complications,anterior margin before and after operation,the recovery of central,trailing edge height,Cobb Angle changes before and after operation,acquisition oswesty disability index(ODI)before and after operation,visual analogue score(VAS)and other relevant data,scientific system of evaluation of the protruding after PKP degree of ease after treatment in patients with clinical symptoms and vertebral,spine imaging changes,assessment of the protruding after PKP treatment the clinical effect of vertebral osteoporotic compression fractures.ResultsAll patients were followed up,patients were followed up for 3 to 6 months.Results showed that after PKP treating patients postoperative chest waist most obvious pain relief.Intraoperative blood loss are less than 5 ml;the mean duration of anesthesia and surgery for(65.43 ± 18.58)minutes;the mean length of hospital stay(3.71 ±2.40)days;a single vertebral body bone cement injection is on average(3.33±1.00)ml;12 vertebral choose bilateral pedicle puncture establishing working channel,27 single line on the right side of the vertebral bodies pedicle puncture,19 single line on the left side of the vertebral bodies pedicle puncture;postoperative 3 vertebral body bone cement leakage,two vertebral bodies for vertebral side leakage,1 vertebral body as the spinal canal leakage,but no nerve compression and other related clinical symptoms occurred;three days after review of imaging examination showed anterior margin,central,trailing edge height recovery,compared with the preoperative data,obvious difference(P<0.001),statistically significant;three days after,the ODI index,VAS score decreased significantly compared with the preoperative data,obvious difference(P<0.001),statistically significant;three days after,Cobb Angle change obviously compared with the preoperative data,obvious difference(P<0.001),statistically significant;Cobb Angle after 3 months compared with after 3 days,no significant difference(P>0.05),no statistical significance.Conclusion Percutaneous kyphoplasty is an effective treatment for the treatment ofosteoporotic compression fractures in elderly patients with thoracolumbar spine fractures.It has the advantages of small surgical trauma,short operation time,short hospital stay,rapid and obvious improvement of thoracolumbar pain,bone cement leakage complications low,effectively improve the disease front,middle,trailing height,correct patients with kyphosis and other advantages.It has high clinical value. |
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