| Objective:To observe the application of injectable artificial bone powder in percutaneous kyphoplasty combined with postoperative oral Bushen Zhuangjin decoction in the near-term and mid-term clinical efficacy.Methods:A retrospective analysis of 40 cases of single osteoporotic thoracolumbar fracture from January 2016 to June 2017 in Hubei Hospital of TCM was performed with percutaneous kyphoplasty and postoperative oral administration of Bushen Zhuangjin decoction.Injectable artificial bone powder and polymethylmethacrylate bone cement(PMMA)were used for percutaneous kyphoplasty.After the operation,according to the patient's wishes,Bushen Zhuangjin decoction was taken orally.According to the two treatment methods,the vertebral body filler was injectable artificial bone powder combined with internal medicine group(observation group): 21 cases in total,including 4 males and 17 females,aged 59-85 years,average 73.95±10.29 aged;vertebral body filler is polymethylmethacrylate bone cement with internal medicine group(control group): a total of 19 cases,including 3 males and 16 females,aged 61-84 years old,with an average of 72.37±7.85 years old.Both groups were treated with Bushen Zhuangjin decoction after operation for 1 month.The VAS pain score,Cobb angle,Oswestry dysfunction index,and the percentage of the vertebral anterior height of the injured vertebra were measured before surgery and on 2nd day,3rd,and 6th month after surgery to evaluate the efficacy of two kinds of vertebral body fillers and Bushen Zhuangjin decoction in the treatment of osteoporotic vertebral fractures.Results:All the 40 cases were followed up for 6 months.All patients met the standard of clinical recovery.The pains of patients in both groups were significantly relieved.All patients had no injectable artificial bone powder or bone cement leakage and nerve root symptoms.During the follow-up period,there is not vertebral fractures occurred again in all patients.The VAS pain score on the 2nd day after surgery in both groups were significantly lower than preoperative,and the differences were statistically significant(P<0.05).There was no significant difference in VAS pain scores among the 2nd day,3rd and 6th month after operation(P>0.05).The differences in the Cobb angle between the two groups before and after the PKP operation were analyzed.The kyphotic Cobb angle before PKP surgery was statistically significant in both groups compared with 2nd day after the operation(P<0.05).There was no significant difference between the two groups on the 2nd day,3rd and 6th month after operation(P>0.05).Compared with the Oswestry disability index of the two groups,the postoperative Oswestry disability index was significantly reduced on the 2nd day after surgery,indicating that both vertebral body fillers can improve spinal function better.There was no significant difference in the data between the observation group and the control group at each time point(P>0.05).This indicates that the two treatment methods have equivalent curative effect on the improvement of spinal function.The percentage of vertebral body anterior height on the 2nd day after the operation was statistically different from preoperation(P<0.05).There was no significant difference between the observation group and the control group at each time point(P>0.05).This shows that PKP surgery can better restore the collapse of the vertebral height and the two treatment methods for the recovery of vertebral height is not very different.Conclusion: PKP injection of injectable artificial bone powder and postoperative adjuvant Bushen Zhuangjin decoction for the treatment of osteoporotic vertebral fractures have the same efficacy as PKP-filled bone cement and postoperative adjuvant Bushen Zhuangjin decoction,all of which can improve the Cobb angle and the vertebral body anterior height,relieve the pain of the patients and improve the quality of daily life without obvious complications. |
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