| OBJECTIVE: To analyze the clinical data of patients who diagnosed as thoracic vertebral osteoporotic vertebral compression fracture(OVCF)and treated by Percutaneous kyphoplasty(PKP)from January 2015 to December 2017 in our hospital to explore PKP for elderly patients with thoracic vertebral OVCF pulmonary function,and analysis of what factors are related to improve the improvement of lung function.Methods:We selected the patient in the first Hospital of Lanzhou university from January 2015 to December 2017,treated by PKP,digonsed as thoracic vertebral OVCF,accord with inclusion criteria,discharge standards,diagnostic criteria,clinical data collected in patients,A total of 23 cases of clinical data collection.we collected the cobb angle of kyphosis,cobb angle of kyphosis,visual analogue scale(VAS)and pulmonary function indexes were collected before and 3 days after operation and at the last follow-up.Pulmonary function indexes included vital capacity(VC),maximum ventilation(MVV),forced vital capacity(FVC)and forced expiratory volume one second(FEV1)using statistical methods to analyze the correlation between preoperative,postoperative 3d and the last follow-up Data,and preoperative and postoperative 3d,respectively,the cobb angle,local Cobb angle and VAS score improvement and various lung function improvement,postoperative 3d-the last follow-up coxillary kyphosis,local Cobb angle and VAS correlation analysis between scores improvement and various lung function improvement values.Result:The Cobb angle of patients with kyphosis was significantly lower than that of preoperative(46.31 ± 11.52)and postoperative 3d(37.10 ± 10.63),the difference was statistically significant(P<0.05),the last follow-up(36.92 ± 10.80)compared with preoperative(46.31 ± 11.52)the difference was statistically significant(P <0.05).The difference between the last follow-up(36.92 ± 10.80)and postoperative 3d(37.10 ± 10.63)was not significant(P> 0.05),and postoperative 3d(13.03 ± 3.13),the difference was statistically significant(P <0.05),the last follow-up(13.1 ± 53.10)compared with preoperative(22.63 ± 6.36),the difference was statistically significant(P <0.05),the last follow-up(13.15 ± 3.10)compared with postoperative3d(13.03 ± 3.13),the difference was not statistically significant(P> 0.05);VAS score before surgery(6.91 ± 1.23)compared with postoperative 3d(1.83 ± 0.65),the difference was statistically significant(P <0.05),the last follow-up(1.61 ± 0.83)compared with before surgery(6.91 ± 1.23),the difference was statistically significant(P <0.05),,the last follow-up(1.61 ± 0.83)compared with postoperative 3d(1.83 ± 0.65),the difference was not statistically significant(P> 0.05);patients underwent preoperative VC(2.28 ± 0.43)compared with postoperative 3d(2.56 ± 0.39),The difference was statistically significant(P<0.05).The difference between the last follow-up(2.59 ± 0.40)and preoperative(2.28 ± 0.43)was statistically significant(P <0.05).The difference between the last follow-up(2.59 ± 0.40)and postoperative 3d(2.56 ± 0.39)Compared with,the difference was not statistically significant(P>0.05);the preoperative MVV(55.39 ± 7.56)compared with postoperative 3d(62.50 ± 7.36),the difference was statistically significant,the last follow-up(62.72 ± 7.43)Compared with preoperative(55.39 ± 7.56),the difference was statistically significant(P <0.05).The difference between the last follow-up(62.72 ± 7.43)and postoperative 3d(62.50 ± 7.36)was not significant(P>0.05),the difference was statistically significant(P<0.05)between the preoperative FVC(2.14 ± 0.44)and postoperative 3d(2.38 ± 0.51),at the last follow-up(2.39 ± 0.41)and preoperative(2.14 ± 0.44)and postoperative 3d(2.38 ± 0.51),the difference was not statistically significant(P>0.05);the FEV1 preoperative(1.90 ± 0.21)compared with postoperative 3d(2.11 ± 0.23),the difference was statistically significant(P <0.05),the last follow-up(2.12 ± 0.27)compared with preoperative(1.90 ± 0.21),the difference was statistically significant(P <0.05),the last follow-up(2.12 ± 0.27)compared with 3d(2.11 ± 0.23),the difference was not statistically significant(P>0.05);Correlation analysis of preoperative-postoperative 3 days improvement of kyphosis and Cobb angle of kyphosis with preoperative-postoperative 3 days improvement(VC: r=0.490,P<0.05;FVC: r=0.434,P<0.05;MVV: r=0.443,P<0.05;FEV1: r=0.524,P<0.05;)Correlation analysis of improved value of postoperative 3d-colobal angle of Cobb angle after kyphotic surgery and improvement of pulmonary function after 3d-final follow-up(VC: r=0.087,P>0.05;FVC:r=0.236,P>0.05;MVV: r=0.202,P>0.05;FEV1: r=0.003,P>0.05),preoperative-last-time follow-up improvement of kyphotic Cobb angle Correlativity analysis of value and improvement of preoperative-final follow-up for pulmonary function(VC: r=0.572,P<0.05;FVC: r=0.427,P<0.05;MVV: r=0.425,P<0.05;FEV1: r=0.453(P<0.05);correlation between preoperative-postoperative 3 days VAS score improvement and pulmonary function preoperative-postoperative 3 days improvement(VC: r=0.592,P<0.05;FVC: r=0.472,P<0.05;MVV: r=0.431,P<0.05;FEV1: r=0.453,P<0.05).Correlation analysis between the improved value of VAS score and the improvement value of lung function after 3d-final follow-up after operation(VC: r= 0.294,P>0.05;FVC: r=0.007,P>0.05;MVV: r=0.397,P>0.05;FEV1: r=0.077(P>0.05),Correlation analysis between improved value of VAS score and preoperative-final follow-up improvement of pulmonary function before and after follow-up(VC: r=0.576,P<0.05;FVC: r=0.421,P<0.05;MVV :r=0.503,P<0.05;FEV1:r=0.516,P<0.05;);Correlation analysis of preoperative-postoperative 3 days improvement of local kyphosis Cobb angle and preoperative-postoperative 3 days improvement(VC):r=0.162,P>0.05;FVC: r=0.018,P>0.05;MVV: r=0.023,P>0.05;FEV1: r=0.021,P>0.05;),local kyphosis Cobb angle 3d.Correlativity analysis between the improved value of the last follow-up and the improvement value of lung function after 3d-final follow-up(VC: r=0.005,P>0.05;FVC: r=0.116,P>0.05;MVV: r=0.140,P>0.05;FEV1 :r=0.108,P>0.05;),Correlation analysis between the improved value of the pre-and post-operative follow-up of local kyphosis Cobb angle and the preoperative-final follow-up improvement of pulmonary function(VC:r=0.132,P>0.05;FVC:r = 0.015,P> 0.05;MVV: r =0.020,P> 0.05;FEV1: r = 0.001,P> 0.05).Correlation between the degree of improvement of the Cobb angle of the kyphosis and the degree of improvement of the VAS score: preoperative-postoperative 3 days Correlative analysis of improved Cobb angle of kyphosis and VAS score improvement(r=0.301,P>0.05);Correlation between Kaposi's Cobb angle improvement and VAS score before and after the final follow-up(r=0.112,P>0.05);3d after surgery-Last postoperative follow-up:(r=0.061,P> 0.05).Conclusion: PKP is effective for elderly patients with thoracic OVCF,can improve the deformity of thoracic kyphosis and effectively relieve the symptoms of low back pain in patients,and has a good improvement effect on damaged VC,FVC,MVV and FEV1.The preoperative and postoperative improvement of thoracic kyphotic Cobb angle and VAS score were correlated with the improvement of preoperative and postoperative VC,FVC and MVV.The preoperative and postoperative follow-up Cobb angle improvement and The improvement of VAS score was positively correlated with the improvement of VC,FVC,MVV and FEV1 in preoperative and final follow-up. |
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