| Objective:To analyse the effects of unipedicular percutaneous kyphoplasty(PKP)in the treatment of osteoporotic vertebral compression fracture(OVCF).Method:A retrospective analysis of 36 cases of OVCF patients(41 vertebrae)in Spinal Surgery at Yanbian University Affiliated Hospital treated by unilateral PKP from September 2015 to December 2017 was made,including 9 cases with T12 fracture,13 cases with L1 fracture,3 cases with L2 fracture,3 cases with L3 fracture,3 cases with L4 fracture,1 case with L5 fracture,1 case with T12,L1 fracture,1 case with L1,L4 fracture,1 case with T12,L3 fracture,1 case with T12,L2 L3 fracture.All patients were followed up for 3 months.The visual analogue scale(VAS),Oswestry disability index(ODI),kyphotic Cobb angle and before and after operation were recorded and analysed.According to the results of postoperative imaging review,the patients were divided into a bone cement non cross-midline group(n=20)and bone cement cross-midline group(n=16),followed by the comparison of VAS score,ODI score,and kyphotic Cobb angle in the two groups before,1st postoperative day,the 1st postoperative month,3rd postoperative month,and to analyze the distribution of the bone cement in vertebrae and the effect on unilateral PKP efficacy,so as to evaluate the clinical efficacy of unilateral PKP.Results:1.All patients’operation time of 15-70min,an average of 25.7 ± 10.6min,vertebral bone cement perfusion volume of 1.0-4.5ml,an average of 2.9 ± 0.9ml.Among the 41 vertebrae,there were 10 cases of bone cement leakage,including 4 cases of needle leakage,3 cases of anterior vertebral leakage,2 cases of paravertebral soft tissue leakage,and l case of intervertebral disc leakage,without clinical symptoms.There are no serious complications such as nerve root and spinal cord injury and pulmonary embolism of bone cement.2.Preoperative VAS score was 7.7±1.2 while the VAS score on the 1st postoperative day was 7.7± 1.2,1.7±0.6 on the 1st postoperative month,1.6±0.6 on the 3rd postoperative month.The VAS scores at various postoperative time points were statistically different from those before operation,with statistical significance(P<0.05);the preoperative ODI score was 71.1 ± 12.8,and the ODI score on the first day after operation was 60.3±6.1,one month after operation was 23.8±8.3 and three months after operation was 24.5±6.7.The ODI scores at various postoperative time points were statistically different from those before operation,with statistical significance(P<0.05);preoperative kyphosis Cobb angle was 16.1±4.0°,while on the first day after operation is 12.2±2.7°,1 month after the operation 12.4±2.6°and 3 months after operation 12.6±3.0°,respectively.The kyphosis Cobb angle at various postoperative time points were statistically different from those before operation,with statistical significance(P<0.05).3.There difference in VAS scores and ODI scores between the cement non cross-midline group and the cement cross-midline group at each time point after operation was no statistical significance(P>0.05).However,the improvement of the kyphosis Cobb angle in the cross-midline group was better than that in the non cross-midline group at each time point after operation,and the difference was statistically significant(P<0.05).Conclusion:1.Unipedicular percutaneous kyphoplasty for the treatment of osteoporotic vertebral compression fractures can relieve pain effectively,correct the kyphosis Cobb angle,and no loss of angle occurs in the short term,which improved the quality of life of patients significantly with positive treatment effect.2.There was no correlation between the distribution of bone cement in the vertebral body and the degree of pain relief and quality of life improvement.However,when bone cement distribution exceeded the vertebral midline,the correction effect of the injured kyphotic Cobb angle was superior to that without exceeding the vertebral midline.3.Long-term follow-up and further clinical observation were required for the loss of kyphotic Cobb angle after unipedicular percutaneous kyphoplasty and adjacent fractures. |
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