The Clinical Comparative Study Between Cushion Pillow And Functional Exercise Therapy Combined With Percutaneous Vertebroplasty And Percutaneous Kyphoplasty In The Treatment Of Osteoporotic Vertebral Compression Fractures

Objective:Compare the intermediate-short-term efficacy and complications of the cushion pillow and functional exercise therapy combined with Percutaneous Vertebroplasty(PVP)and the Percutaneous Kyphoplasty(PKP)in the treatment of osteoporotic vertebral compression fractures(OVCF),provide a basis for clinical selection of economic,safe and effective treatment of OVCF.Methods: Retrospectively analyzed the clinical data of 57 patients with OVCF to the Orthopedics of Hospital(T.C.M)affiliated to Southwest Medical University from October 2014 to March 2016,divided into A,B two groups according to the treatment method,A group of 26 cases used the the cushion pillow and functional exercise therapy combined with PVP treatment,B group of 31 cases treated by PKP.All patients underwent the visual analogue scale(VAS)at admission,preoperative 3 days and postoperative 3 days,1 month,3 months,6 months,and 12 months,regularly shot X-pieces to calculate the altitude loss rate and kyphosis Cobb angle of injured vertebral body,observed and recorded the intraoperative leakage of bone cement,performed the follow-up of postoperative fractures in adjacent vertebra,counted and analyzed the changes in each study index of the two groups of general information,postoperative general situation,group,different treatment time points within groups and the same treatment time points between groups.Results: 1.General data comparison: There was no significant difference between the two groups in age,gender,course of disease and the compression degree of injured vertebral,(P > 0.05),the study was comparable.2.Comparison of postoperative general situation: A group of bone cement injection volume,operation time,hospitalization costs were significantly lower than the B group,the difference was statistically significant(P < 0.01);But the hospitalization time of A group was significantly longer than that of B group,the difference was statistically significant(P < 0.01).3.VAS score comparison: There was no statistical difference between the two groups(P > 0.05)at admission;the postoperative VAS scores in different time points of the two groups were significantly lower than those at admission and preoperative(P?0.01);there was no significant difference in postoperative VAS score in different time points between the two groups(P > 0.05).4.Comparison of vertebral altitude loss rate: There was no statistical difference between the two groups(P > 0.05)at admission;in group A,the preoperative vertebral altitude loss rate was significantly improved compared with admission(P < 0.01),there was no significant difference in postoperative vertebral altitude loss rate in different time points compared with preoperative;in group B,there was no statistical difference between admission and preoperative(P?0.05),the vertebral altitude loss rate was significantly improved at different time points after operation(P < 0.01),there was certain repeat loss of vertebral height at 1 month,3 months,6 months and 12 months compared with postoperative 3 days(P <0.01),there was no significant difference between the two groups after 1 month,3 months,6 months and 12 months(P> 0.05).5.Comparison of kyphosis Cobb angle: There was no statisticaldifference between the two groups(P > 0.05)at admission;in group A,the preoperative kyphosis Cobb angle was significantly improved compared with admission(P < 0.01),there was no significant difference in postoperative kyphosis Cobb angle in different time points compared with preoperative;in group B,there was no statistical difference between admission and preoperative(P?0.05),the kyphosis Cobb angle was significantly improved at different time points after operation(P < 0.01),there was certain secondary augmentation of kyphosis Cobb angle at 1 month,3 months,6 months and 12 months compared with postoperative 3 days(P <0.01),there was no significant difference between the two groups after 1 month,3 months,6 months and 12 months(P>0.05).6.Comparison of permeability of ploymethylmethacrylata:A group was 12.50%(4/32),B group was 17.95%(7/39),there was no significant difference between the two groups(P > 0.05).7.Comparison of the probability of postoperative fractures in adjacent vertebrae: A group was 11.54%(3/26),B group was 16.13%(5/31),there was no significant difference between the two groups(P > 0.05).Conclusions: The cushion pillow and functional exercise therapy combined with PVP and the PKP could ctively relieve pain,restore the altitude of the injured vertebrae,correction of kyphosis in the treatment of OVCF,the cushion pillow and functional exercise therapy combined with PVP was superior to PKP in the low cost and short operation time,the postoperative vertebral height and kyphosis Cobb angle were not significantly changed,the cushion pillow and functional exercise therapy combined with PVP was an economic,safe and effective treatment for OVCF.