Efficacy And Complication Analysis Of Percutaneous Kyphoplasty For Fresh And Old Vertebral Compression Fractures

Objective:To compare the efficacy and complications of percutaneous kyphoplasty in the treatment of fresh and old osteoporotic vertebral compression fractures.Methods:A retrospective study was conducted to analyze 142 patients with osteoporosis vertebral compression fractures who received percutaneous kyphoplasty in Shanxi Dayi hospital from June 2017 to October 2018.81 cases of single vertebral fracture with definite injury time were screened out.According to the time of injury,there were 54 cases in the fresh fracture group(<2 weeks)and 27 cases in the old fracture group(>6 weeks),by comparing the visual analogue score,Cobb angle,and compression rate of anterior edge of vertebra among preoperative and postoperative 2 days,3 months,and the last follow-up,to evaluation the efficacy of surgical.The incidence of surgical complications such as bone cement leakage and adjacent vertebral fracture was compared between the fresh fracture group and the old fracture group,so as to evaluate the surgical safety.Results:Comparison of surgical efficacy: in the fresh and old fracture group,VAS score and Cobb angle were improved in each postoperative period and preoperative period,and the difference was statistically significant(P<0.05).There was no significant difference in VAS score between fresh and old fracture groups(P>0.05).The difference of Cobb angle between fresh group and old group was statistically significant(P<0.05).There were statistically significant differences between the fresh group and the old group in anterior vertebral margin correction 2 days after surgery(P<0.05),and the values of vertebral body margin height and kyphosis angle correction 2 days after surgery in the fresh group were higher than those in the old group.Complications: a total of 15 cases(18.52%)had complications.Bone cement leakage occurred in 8 cases(9.87%).During the follow-up period,7 cases(8.64%)of adjacent vertebral body fractures were reported.Compared with the fresh group,there was no statistically significant difference in bone cement leakage rate between the old group and the fresh group(P>0.05),and the re-occurrence rate of adjacent vertebral fracture in the old group was higher than that in the fresh group,and the difference in incidence was statistically significant(P <0.05).Conclusion: PKP is an effective method for the treatment of fresh and old osteoporosis vertebral compression fractures,which can quickly relieve pain symptoms,restore vertebral height and correct kyphosis,but the fresh fracture group has better efficacy than the old group in restoring vertebral height and correcting kyphosis.In terms of surgical complications,cement leakage and fracture of adjacent vertebrae occurred in both groups,and the incidence was higher in the old group than in the fresh group.Therefore,early PKP treatment for OVCF patients is of great significance for improving the surgical efficacy and reducing the recurrence of adjacent vertebral fractures.