| Objective:This study analyzed retrospectively 87 cases of different degrees of osteoporotic thoracolumbar compression fractures(osteporotic vertebral compression will fracture,OVCF)in patients with preoperative and postoperative imaging data and mid-and long-term follow-up.and It was evaluated comprehensively the surgery effect of percutaneous kyphoplasty(percutaneous kyphoplasty,PKP)in the treatment of different degrees of OVCF.To provide the reference for clinicians.Clinical data and methods:The selected patients of CT examination showed that the posterior wall of the vertebral body was intact,there was no occupation in the vertebral canal,bone density test confirmed osteoporosis,there was a clear history of trauma,and the time of fracture within two weeks was acute or subacute single vertebral fracture with severe lumbar and back pain from June 2016 to June 2017 were admitted to Jilin University China-Japan Friendship Hospital.A total of 87 patients underwent percutaneous kyphoplasty(PKP),All87 postoperative patients were followed up until January 2019,including 35 males and 52 females,aged 55-93 years,with an average age of 69.71±8.66 years.A total of 87 vertebral bodies were accumulated,including thoracic 12fractures:37 vertebral bodies,lumbar 1 fractures:39 vertebral bodies and lumbar 2 fractures:11 vertebral bodies.According to the patient’s preoperative X-ray.Patients were divided into three groups according to the ratio of the anterior margin compression height to the posterior margin height: mild compression group(<30%),moderate compression group(30%-50%),and severe compression group(>50%),the severe compression group needs to exclude the posterior ligament composite structure damage,among which 28 cases were in the mild compression group,37 cases in the moderate compression group,and 22 cases in the severe compression group.The preoperative and postoperative VAS score were recorded.According to the imaging data of patient’s preoperative and postoperative and follow-up,recorded patient’s vertebral leading edge height、leading edge height recovery、compression rate recovery、height recovery rate、local kyphosis angle and complications: bone cement leakage 、 neurological symptoms 、recurrent vertebral fracture.Results:1、VAS score:There were significant difference in preoperative and postoperative VAS score between the three groups(P<0.05).There was no significant difference in preoperative VAS score between the groups(P>0.05).There was no significant difference in postoperative VAS score between the groups.(P>0.05)2、Vertebral height,vertebral compression rate,local kyphosis:Therewere significant differences in vertebral height,vertebral compression rate and local kyphosis between the three groups in the Pre-operation and postoperaton.(P>0.05)3、The height recovery and compression rate recovery of the moderate and severe compression group were significantly better than those of the mild compression group(P<0.05),but there was no statistically significant difference between the moderate and severe compression groups(P>0.05).The high recovery rate of the mild compression group was significantly better than that of the severe compression group and there was significant statistical difference between the group(P<0.05),but there was no significant difference between the moderate compression group and the mild、severe compression group(P>0.05)4、Bone cement leakage and neurological symptoms:All OVCF patients treated with PKP surgery,There was 1 case of bone cement leakage in mild compression group,The incidence rate of 1 case(intervertebral disc leakage)of bone cement leakage in mild compression group was(1.3%,1/28);The incidence rate of 7 cases(2 cases of intervertebral space leakage,5 cases of paravertebral soft tissue leakage)of bone cement leakage in moderate compression group was(18.9%,7/37);The incidence rate of 79cases(1 case of epidural leakage,3 cases of intervertebral space leakage,5 cases of paravertebral soft tissue leakage)of bone cement leakage in severcompression group was(40.9%,9/22);All three groups of patients completed the operation safely,and there were no postoperative neurological symptoms.5 、 Recurrent vertebral fracture:All OVCF patients treated with PKP surgery,a total of 2 patients had recurrent vertebral fracture and all occurred in the severe compression group.1 case was a recurrent fracture of the injured vertebra,and 1 case was a fractured vertebra with other vertebral fracture.Five and thirteen months after operation,respectively.Conclusion:1 、 PKP is safe and effective for patients with different degrees of vertebral compression fractures,and has a good pain relief effect,which can significantly improve the quality of life of patients.2、For patients with OVCF with large degree of vertebral compression,the Leading edge height and compression rate of the vertebral body are better after PKP treatment,but it is more difficult to restore the injured vertebra to the original height.3、For patients with OVCF with greater degree of vertebral compression,attention should be paid to bone cement leakage and recurrent vertebral fractures through PKP treatment. |
