| Background Osteoporosis is a systemic disease because of decreased bone mass,bone quality,reduce bone strength damage and lead to increased bone fragility and susceptibility to fractures.It is a common disease and frequently occurring disease of the elderly.Osteoporotic fracture is the main clinical manifestation of osteoporosis in the elderly.It has seriously affected the quality of life and survival rate of the elderly,and has brought serious family and social and economic burden.Vertebral compression fractures are the most common type of vertebral fractures,and the most common type of osteoporotic fractures.The most common clinical manifestation of osteoporotic compression fractures is:severe back pain,kyphosis,height,chest abdominal cavity volume decrease and so on.With the development of medical technology in recent years,The treatment of osteoporotic compression fractures,in addition to conservative,open reduction and internal fixation,and other treatment methods.Percutaneous percutaneous PVP,percutaneous percutaneous PKP also played a crucial role.Even now PVP and PKP has become the treatment of osteoporotic compression fracture of the first choice for treatment of pain?vertebroplasty percutaneous,through percutaneous puncture,through the pedicle channel into the vertebral body,and bone cement injection.The advantages are : stable fracture and ease pain rapidly,shorten hospital stay,promote patients with early bed activities,shorten the operation time,reduce fracture complications,easy to operate,to speed up the recovery and so on.Nowadays,PVP has gradually become the first choice for the treatment of vertebral fractures.The difference between PVP and PKP are the direct injection into the vertebral bone cement modified operation for the first use of balloon,vertebral deformity correction,and then the bone cement injected into the cavity.The reform of the operation style has solved many problems,but it also brings new problems.At present,there are still academic differences between PKP and PVP.For example,to determine the indications,etc...Purpose The aim of this study is to compare the efficacy of PVP and PKP in the treatment of osteoporotic fracture of lumbar spine,and hope to guide the clinical treatment.Methods Collect the cases from The total hospital of First Affiliated Hospital of Xinxiang Medical College and Hebi Meitan Hospital from 2013 01 to 2016 01 months,and diagnose as “lumbar compression fracture ”,surgical treatment via PVP or PKP.Through the inclusion criteria and exclusion criteria were excluded,are divided into two groups,PVP treatment group and PKP treatment group.Each group contains 30 people,30 vertebral body.Take the same preoperative preparation and postoperative treatment.PVP group and PKP group are treated with PVP surgery and PKP surgery methods for patients with surgery.And the data obtained are statistically analyzed.General information using contingency table chi square test,each group of data are using mean standard deviation(X±S)to indicate.Preoperative and postoperative VAS scores,vertebral body leading edge,middle height and posterior convex angle were compared by paired T test.The difference of the recovery of the age,length of stay,operation cost,operation time,operation time,VAS score,anterior height of vertebral body,middle height and posterior convex angle were analyzed by independent sample T test.Two groups of surgical bone cement leakage rate using a list of chi square test,the test level of a=0.05,P < 0.05 for a statistically significant.Result1.Sex,Location:By means of the accurate probability method,the 60 cases of all PVP group and PKP group,17 cases were male,accounting for 28.3%;female 43 cases,accounting for 71.7%.L1 vertebral body in 31 cases,accounting for 51.7%;L2 vertebral body in 13 cases,accounting for 21.7%;L3 vertebral body in 6 cases,accounting for 10%;L4 vertebral body in 8 cases,accounting for 13.3%;L5 vertebral body in 2 cases,accounting for 3.3%.2.Age:Group PVP was 71.3±8.305 years old;group PKP was74.67±8.957 years old.By Mann-Whitney U test,P=0.255 > 0.100,the age of the two groups had no significant difference,that is,there was no significant difference.3.Hospital days:The length of stay in group PVP was 6.83±2.102 days;the length of stay in group PKP was 8.57±5.450 days.T test was P=0.110 > 0.100,there was no significant difference in the length of hospital stay between the two groups,that is,there was no significant difference.4.Hospital days after surgery:The length of stay in group PVP was3.17±1.315 days;the length of stay in group PKP was 3.57±1.612 days.By Mann-Whitney U test,P=0.379>0.100,two groups of postoperative hospital stay was not statistically significant,that is,no significant difference.5.Preoperative VAS score : PVP group preoperative VAS score 7.03±1.299 points;PKP group preoperative VAS score7.27±1.574 points;By Mann-Whitney U test,P=0.500>0.100,two groups of preoperative VAS score no significant statistical significance,that is,no significant difference.6.Postoperative VAS score:Group VAS after operation,the PVP score was1.23±1.006,and the VAS score of group PKP was 1.63±0.964.By Mann-Whitney U test,P=0.149 > 0.100,two groups of postoperative VAS score was not statistically significant,there was no significant difference.7.Within group comparison :(7.1)Preoperative and postoperative VAS scores:PVP group T=14.631,P=0.000<0.05;PKP group T=19.272,P=0.000 < 0.05.PVP group and PKP group after treatment,the two groups before and after the VAS score was statistically significant.(7.2)Anterior height of vertebral body : The anterior height of vertebral body height of PVP group was 1.990±0.368 cm,the height of anterior vertebral body height was 2.170 ± 0.433 cm,the anterior height of vertebral body height was 2.003 ±0.527 cm,and the height of anterior vertebral height was 2.567 ± 0.371 cm.In group PVP,T=-3.692,P=0.001 < 0.05;PKP group,T=-7.807 group P=0.000 < 0.05.After treatment,PVP group and PKP group after treatment,the two groups before the operation of the vertebral body leading edge height has obvious statistical significance.(7.3)Middle height of vertebral body:Anterior vertebral height of PVP group was 1.737 ± 0.301cm;After operation,the middle height of the vertebral body was 2.017±0.301cm;Anterior vertebral height of PKP group was1.860±0.388cm;After operation,the middle height of the vertebral body was 2.510 ±0.300 cm.In group PVP,T=-3.692,P=0.000 < 0.05;T=-7.807 group P=0.000,PKP <0.05.After treatment,PVP group and PKP group after treatment,the two groups of preoperative and postoperative vertebral body height had obvious statistical significance.(7.4)Cobb angle:Group Cobb preoperative PVP angle 22.170 ± 4.900°;Postoperative Cobb angle16.970±5.021°;Cobb group preoperative PKP angle 20.570±5.946°;Postoperative Cobb angle 12.63±5.062°.PVP group T=-3.692,P=0.000<0.05;PKP group T=-7.807,P=0.000<0.05.PVP group and PKP group after treatment,the two groups of preoperative Cobb angle had obvious statistical significance.8.Comparison between groups:Through the PVP group and PKP group,the anterior height of the vertebral body restoration,the middle height of the vertebral body recovery,Cobb angle recovery,VAS score of the difference between the independent samples T test,the results are as follows:VAS score difference T=0.341,P=0.734 > 0.05,There was no significant difference in PVP group and PKP group,there was no significant difference in the change of VAS score,the two groups had no significant difference in the change of postoperative pain.Vertebral height recovery difference T=-4.402,P=0.000<0.05,and the difference was statistically significant;Middle height difference of vertebral body T=-3.984,P=0.000<0.05,and the difference was statistically significant;Cobb angle recovery difference T=-2.751,P=0.009<0.05,and the difference was statistically significant.In group PVP and group PKP,the height of anterior vertebral body was recovered,the recovery of middle height of vertebral body and the recovery of Cobb angle were different.9.Adverse reactions and complications:No adverse reactions and complications were found in the PVP group and the PKP group,and no severe complications were found in the follow-up after March.Conclusion1.Osteoporotic vertebral fractures were more common in women than in men,and L1 was more common in other lumbar vertebral bodies;2.PVP,PKP two kinds of surgery to relieve the pain of patients,restore the height of the vertebral body,restore the height of the vertebral body,restore the vertebral Cobb angle has a significant effect;3.There were no significant differences in pain,length of stay and length of stay in hospital between PVP and PKP in two kinds of surgical procedures.;4.PVP,PKP two kinds of surgical procedures for the restoration of the height of the anterior vertebral height,the recovery of the middle height of the vertebral body,the recovery of Cobb angle of the vertebral body are different.PKP is better than PVP?... |
PDF Full Text Request