| ObjectiveWe will analyze the percutaneous vertebroplasty clinical efficacy firstly,then compare the clinical efficacy of percutaneous vertebroplasty which was injected by different bone cement injection way and the different amount of bone cement.MethodsTo analyze 180 cases of clinical data of patients with painful osteoporotic vertebral compression fractures who accepted treatments from January of 2015 to December of2017 in the Hospital which I studied.We exclude 11 patients’data caused by death or lost in the process of postoperative follow-up.At last the 169 patients suffered from OVCF,118 female cases and 51 male cases were collected,all patients were older than50 years old.The efficacy was assessed at newly hospitalized inpatient,at the second day after operation and at the third month after operation.Both visual analogue scale（VAS）and Oswestry disability index（ODI）were used to assess the efficacy at every time point.The data were collected to be analyzed statistically.Firstly comparing the analysis of efficacy before and after surgery,then analyzing the data which by two different way（unilateral and bilateral）of injection of bone cement,finally less than 5ml each of the following cases of bone cement marked as low dose group,more than 5ml marked as high dose group.and try to analyze the efficacy of treatment method of two different amount of bone cement if there is a difference between them.The resultsTotally there are 180 cases met the inclusion criteria,total deaths and people who lost to follow-up were 11 cases,so 169 cases completed the 3 month’s following visits totally.There were 59 cases in the unilateral injection group and 110 cases in the bilateral injection group,113 cases in the low dose group and 56 cases in the high dose group.There is 10 case of intervertebral bone cement leakage without obvious clinical symptoms.The VAS score1.The VAS score is concluded at newly hospitalized inpatient,then concluding the VAS score at second day after operation and the third month after operation,the analysis of the description data are here:（8.02±1.069）、（4.22±1.298）、（1.54±1.018）.There were significant differences between the VAS score at newly hospitalized inpatient,then concluding the VAS score at second day after operation and the third months after operation（P<0.05）.2.We divided those cases into the unilateral and bilateral injection with bone cement group.respectively,the preoperative VAS score minus the postoperative VAS score at second day named delta VAS1,and then carried out a statistical description,in turn, delta VAS1（unilateral）（3.55±1.453）,delta VAS1（bilateral）（3.93±1.644）,the second day postoperative VAS score minus postoperative at the third month for delta VAS2（unilateral）,（1.88±1.084）,delta VAS2（bilateral）,（2.554±1.246）.Concluded that delta VAS1（unilateral）and delta VAS1（bilateral）has no statistically difference.（P>0.05）,delta VAS2（unilateral）and delta VAS2（bilateral）has statistically difference.（P<0.05）.3.The bone cement injection mount less than 5 ml marked as low bone cement group,patients with more than 5 ml marked as high bone cement group,respectively, the preoperative VAS score minus the second day postoperative VAS score named delta VAS1,and then carried out a statistical description,in turn,delta VAS1（low dose group）（3.63±1.542）,delta VAS1（high dose group）（4.16±1.627）,the postoperative second day VAS score minus the postoperative third month VAS score for delta VAS2（low dose group）,（2.30±1.246）,delta VAS2（high dose group）,（2.36±1.212）.Concluded that delta VAS1（low dose group）and delta VAS1（high dose group）has statistically difference.（P<0.05）,delta VAS2（low dose group）and delta VAS2（high dose group）has statistically difference.（P<0.05）.The ODI index1.The ODI score is concluded at newly hospitalized inpatient,then concluding the ODI score at second day after operation and the third month after operation,and the analyze the description data respectively:（74.44±2.870）、（29.00±3.100）、（16.57±1.519）.There were significant differences between the ODI score at newly hospitalized inpatient,the second day after operation and the third month after operation（P<0.05）.2.We divided those cases into the unilateral and bilateral injection in patients with bone cement group,respectively,the preoperative ODI score minus the second day postoperative ODI score named delta ODI 1,and then carried out a statistical description,in turn,delta ODI 1（unilateral）（43.68±3.584）,delta ODI 1（bilateral）（46.39±3.986）,the second days postoperative ODI score minus the third month postoperative for delta ODI 2（unilateral）,（12.37±3.017）,delta ODI 2（bilateral）,（12.93±3.437）.Concluded that delta ODI 1（unilateral）and delta ODI 1（bilateral）has statistically difference.（P<0.05）,delta ODI 2（unilateral）and delta ODI 2（bilateral）has statistically difference.（P<0.05）.3.The bone cement injection mount less than 5 ml marked as low bone cement group,patients with more than 5 ml marked as high bone cement group,respectively,the preoperative ODI score minus the third day postoperative ODI score named delta ODI1,and then carried out a statistical description,in turn,delta ODI 1（low dose group）（44.35±3.650）,delta ODI 1（high dose group）（47.64±3.961）,the second day postoperative ODI score minus the third month postoperative for delta ODI 2（low dose group）,（10.07±3.127）,delta ODI 2（high dose group）,（13.61±2.821）.Concluded that delta ODI 1(（low dose group）and delta ODI 1（high dose group）has statistically difference.（P<0.05）,delta VAS2(（low dose group）and delta VAS2（high dose group）has statistically difference.（P<0.05）.ConclusionThe PVP treatment is effective in the treatment of OVCF,There are less trauma and shorter time.This operation is a simple operation which has less bleeding.This surgery can be treated with the OVCF and it is earlier,faster,more effective to alleviate the patients’pain,increase vertebral bone strength,improve the stability of the vertebral body,so that the patients will recovery activity function earlily,improve the quality of life,reduce the complications and mortality.1:In the injection under the condition of the same dose,the VAS score reduction and ODI index ease by the unilateral injection and bilateral injection have differences,but the unilateral group’s advantage is not obvious.However,through reading many literatures,everyone agree that bilateral injection of bone cement will extend the operation time and increased the X-ray exposure,increased the soft tissue injuries,so considering the above all,The bilateral injection has no obvious advantage,and has increasing the surgical trauma,extending the operation time,increasing the risk of postoperative infection,so we don’t think the bilateral injection of bone cement is more suitable for clinical.2:The VAS score reduction and ODI index ease by the injection which is high dose of bone cement and the injection named low doses of bone cement have statistical differences,through reading the literature[1]that with the increase of bone cement using,the bone cement leakage also increases,It will increase the risk of surgical complications.Therefore the surgeon increase blindly the amount of bone cement to improve the postoperative curative effect is not a wise choice,it need to depend on the patient’s condition and balanced the pros and cons. |
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