| Background:Osteoporosis(OP)is a kind of chronic disease which is closely related to the endocrine metabolism,bone regeneration and absorption.OP is common in the elderly and postmenopausal women,the OP pathological characteristics is reducing the whole body bones mineral density and bone tissue ultrastructure in different degrees,leading to bone brittleness increases,along with the development of the disease,the overall quality of the bone is falling,greatly increase the risk of bone fracture.The pathological characteristics of OP is reducing the body bone mineral density in different degrees of bone and bone tissue ultrastructure of degradation,resulting in increasing the fragility of the bones.As the disease progresses,the overall quality of the bone gradually decreases,greatly increasing the risk of bone fracture.Since the spine is an important central bone in the human body and is a prone site for osteoporosis,vertebral compression fracture caused by osteoporosis is a common clinical senile disease.Long-term low back pain will occur after fracture of the vertebral body.Especially after the disease develops to a certain degree of severity,compression fractures will occur in multiple adjacent vertebral bodies,and the fracture compression will be more serious.This progressive development usually involves fractures.It will change the normal line of force of the spine,change the normal physiological curvature of the spine,and may cause deformities of varying degrees of spine.If left uncontrolled,pain caused by fractures and kyphosis can cause serious complications such as constipation,malnutrition caused by decreased appetite,decreased lung function,and limited mobility.Multiple and complex complications,which may limit the normal life of the patient and reduce the time spent on exercise and exposure to sunlight,leading to a further increase in osteoporosis.Pain,such as chronic persistent dull pain,which caused by early Osteoporotic Vertebral Compression Fracture(OVCF)is characterized by occult and diversity.Pain at the non-fractures adds to the difficulty of clinical diagnosis and treatment.For patients,non-fracture pain may affect the patient's awareness of medical treatment.Long-term delay in the condition and non-standard anti-osteoporosis treatment will bring challenges to the next step of OVCF treatment.A single conservative or surgical treatment can no longer meet the etiology of OP treatment.Conservative treatment includes rest,external fixation,anti-inflammatory drugs and analgesics.Only a small number of patients with OVCF can be suitable for the conservative treatment.Oral medication may bring more side effects to patients,while conservative treatment cannot delay the development of the disease effectively.The spine vertebral bodies may be affected by external factors and other factors of vertebral osteoporosis,which makes the vertebral body continue to deform.Single conservative treatment cannot interfere with the occurrence of spinal deformation effectively.Therefore,conservative treatment is not recommended for the treatment of OVCF.Surgical treatment is mainly divided into percutaneous vertebroplasty(PVP)and percutaneous kyphoplasty(PKP).PVP and PKP are rapidly and widely used in the treatment of OVCF,vertebral hemangioma or metastases due to their minimally invasive,simple operation,fewer surgical personnel,and rapid relief of pain.Methods:This study was designed to collect data on patients with OVCF treated with PVP or PKP in our hospital,and to follow up the treatment results.The imaging data of patients who were diagnosed as OVCF and treated by PVP or PKP were analyzed.We recorded the different types of pain in OVCF patients.The multiple types of osteoporosis were determined,according to the series of bone markers.The preoperative and postoperative changes of Visual Analogue Scale(VAS)and Oswestry Disability Index(ODI),the height of the upper and lower adjacent intervertebral space of the fractured vertebral body,clinical data such as Cobb angle,vertebral kyphosis of the fracture were recorded.A comprehensive analysis of the relationship between different types of pain and the corresponding imaging findings.The followed-up treatment of PVP or PKP on OVCF were recorded and analyzed.The clinical efficacy of different surgical methods for the treatment of different types of pain caused by OVCF was evaluated comprehensively.Results:A total of 117 patients who met the criteria and were diagnosed by OVCF were excluded were enrolled,according to the patients' medical history,clinical symptoms,physical examinations and imaging examinations.Among all the patients,51 patients with simple vertebral body pain.There were 35 patients had chest and back pain combined with ribs.31 patients with low back or lumbosacral pain.Among the 117 patients,there were 21 patients were male,accounting for 18%of the total number of patients.There were 96 patients were female,accounting for 82%of the total number of patients.The average age of 117 patients was 73.16±8.42 years.T12 and L1 vertebral fractures in OVCF were the most common fractures.A total of 117 patients with OVCF were enrolled in the preoperative examination and the third month follow-up survey.Statistical analysis the relationship of preoperative VAS,ODI score,basic information,bone mineral density,bone turnover type,and possibly related imaging findings in OVCF patients.Results showed no statistical difference of VAS and ODI scores in three groups of patients with different pain types.The difference in pain performance was independent of age,gender,height of adjacent intervertebral space,and type of osteoporotic bone turnover(P>0.05).It is associated with bone mineral density,Cobb angle of vertebral fracture and kyphosis of vertebral fractures(P<0.05).PVP and PKP are two minimally invasive procedures to relieve pain and improve patient mobility,and improve the spinal deformation caused by the OVCF effectively(P<0.05).Conclusion:OVCF has become one of the most common diseases in the elderly.Both PVP and PKP are safe and effective minimally invasive surgical procedures for the treatment of OVCF.Two minimally invasive surgical procedures can effectively improve clinical symptoms.Preoperative and postoperative imaging studies have proved that minimally invasive surgery can effectively restore the height of the fractured vertebral body and improve it.PVP or PKP,can achieve the goal of effective treatment of OVCF.In the treatment of OVCF,the corresponding anti-osteoporosis treatment should be carried out according to the type of bone turnover of the patient,and functional exercise should be strengthened to minimize the risk of bone loss and re-fracture. |
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