Percutaneous Vertebroplasty For The Treatment Of Very Severe Osteoporotic Vertebral Compression Fractures

Objective:Controversy exists regarding percutaneous vertebroplasty(PVP)in patients with a very severe osteoporotic vertebral compression fracture(vsOVCF)which is a kind of complicated disease in clinical practice.The study was conducted to investigate the clinical and radiological outcomes of PVP for the treatment of vsOVCF compared with those of non-vsOVCF.It will provide some directions for the diagnosis and treatment of vsOVCF in the future.Methods:From January 2016 to December 2017,total of 125 consecutive patients who underwent PVP in Guangdong provincial hospital of traditional Chinese medicine were assessed,including 31 patients with vsOVCF(compression more than two-thirds)and 94 patients with non-vsOVCF(compression between 30%and two-thirds).Age,Gender,basic disease,BMI,BMD,operative vertebral segments,The cement volume used,bone cement leakage and Visual analog scale(VAS)scores for back pain,Korean Oswestry disability index(ODI)scores,the height restoration of the vertebral body,and the local kyphotic angle were evaluated preoperatively,postoperatively,and 1 year after treatment.Patients in the non-vsOVCF group who had undergone PVP where compared with those in the non-vsOVCF group.Clinical and radiological outcomes were compared.In addition,complications were evaluated.Results:1.In terms of baseline data such as Gender,Age,BMI,BMD and operative vertebral segment,there was no significant difference between the vsOVCF group and the non-vsOVCF group(P>0.05),but the non-vsOVCF group had a relatively larger number at the history of trauma(P<0.05).When comparing the state of surgery,there was no significant difference between the two groups in cement injection time and puncture method(P>0.05),but for the cement volume used,there was a statistically significant difference between the vsOVCF group and the non-vsovcf group(P<0.05).2.When comparing the preoperative state with the state at the postoperative and 1-year follow-up,it showed that both the vsOVCF group and non-vsOVCF group had a big improvement in the height restoration of the vertebral body,the local kyphotic angle,VAS score,ODI score(P<0.05).3.When comparing the postoperative state with the preoperative state,the two groups did not show any significant differences in terms of the degree of improvement of the local kyphotic angle,the height restoration of the vertebral body,VAS score and ODI score(P>0.05).Besides,the two groups did not show any significant differences in terms of the degree of improvement of the local kyphotic angle,the height restoration of the vertebral body(P>0.05).However,When comparing the preoperative state with the state at the 1-year follow-up,VAS score and ODI score was still relatively high in the vsOVCF(P<0.05).In term of complications,the vsOVCF group had a significantly higher frequency of cement leakage and adjacent segment fracture.Conclusion:percutaneous vertebroplasty is a safe and effective procedure for the treatment of vsOVCF.but its efficacy in the improvement rate of long-term postoperative pain and the incidence of long-term postoperative complications is less than that of non-vsOVCF patients.