| ObjectiveBased on the concept of traditional Chinese osteopathic reduction,combined with vertebroplasty,we try to compare the clinical effect of hyperextension postural reduction combined with percutaneous vertebroplasty(PVP)and percutaneous kyphoplasty(PKP).We observe their clinical curative effect,clinical feasibility and safety,to provide a reliable theoretical support and the corresponding clinical reference for the treatment of osteoporotic vertebral compression fracture(OVCF),attempting to seek the most economic and beneficial project for patients suffered from OVCF.MethodsFrom October 2015 to August 2016,patients suffered from single-level osteoporotic vertebral fracture in the Affiliated Orthopaedic Hospital of Guangzhou University of Chinese Medicine and Third Hospital of Guangzhou University of Chinese Medicine,were divided into the experimental group and the control group according with the standard of experiment by random draw envelope method and one of each group concluded 35 patients.The experimental group conducted hyperextension postural reduction combined with PVP,while the other one received PKP.We observed and recorded the operation time,hospitalization days,hospitalization expenses,the amount of bone cement,VAS score,ODI index,anterior vertebral height,Cobb angle,operational complications and postoperative secondary fracture,and carried out a 6m follow-up of all patients in two groups.We excuted statistical analysis of the differences between the groups at different time points and compared the efficacy of the two groups.Results1)Two groups of patients have successfully completed surgery.All patients do not show bone cement allergy during operation,nor do show postoperative serious complications such as wound infection,vein embolism.2)There is no statistically significant difference in operation time,hospitalization days,bone cement volume between the two groups.3)The hospitalization cost of the experimental group is 2.43±0.36 wan yuan,while the control group is 3.74±0.22 wan yuan.There is statistically significant difference in hospitalization cost and the hospitalization cost of the experimental group is lower than the control group.4)8 cases of the experimental group appeares bone cement leakage leakage,the rate of bone cement leakage is 22.86%;2 cases of the experimental group appeares bone cement leakage leakage,the rate of bone cement leakage is 5.71%.There is statistically significant difference in the rate of bone cement leakage and the rate of bone cement leakage of the experimental group is higher than the control group.5)In the aspect of VAS and ODI scores,experimental group and control group,respectively at the preoperative and postoperative 1 d,postoperative 3 m,6 m,compared between groups,the difference is no statistically significant(P>0.05).The improvement of VAS and ODI scores at different points between groups is no statistically significant.The experimental group and the control group,respectively in the preoperative and postoperative Id,postoperative 3 m,6 m,compared within groups,the difference is statistically significant(P<0.05).The improvement of VAS and ODI scores within groups between preoperative and postoperative is statistically significant.This showed that both treatment programs could relieve pain and improve the quality of life.6)In the aspect of anterior vertebral height,anterior vertebral height recovery rate and Cobb angle,experimental group and control group,respectively in the preoperative and postoperative 1 d,postoperative 3 m,6 m,compared between groups,the difference is no statistically significant(P>0.05).The improvement of anterior vertebral height,anterior vertebral height recovery rate and Cobb angle at different points between groups is no statistically significant.The experimental group and the control group,respectively in the preoperative and postoperative 1 d,postoperative 3 m,6 m,compared within groups,the difference is statistically significant(P<0.05).The improvement of anterior vertebral height,anterior vertebral height recovery rate and Cobb angle within groups between preoperative and postoperative is statistically significant.7)The two groups of patients are followed up for 6m,and all patients have no secondary fractures.ConclusionHyperextension postural reduction combinied with PVP and PKP for patients suffered from OVCF could have equivalent clinical in pain relief and correcting kyphosis.Hyperextension postural reduction combinied with PVP not only makes up for the defects of PVP's poor correction of kyphosis,but also can relieve the pain of patients and improve the quality of life,and achieve the same effect as PKP.In contrasr with PKP,the cost of hyperextension reduction combinied with PVP is much cheaper and hyperextension postural reduction combinied with PVP is worthy of clinical application. |
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