Research And Analysis Of Osteoporotic Vertebral Compression Fracture Re-fracture After Two Methods For Treatment

Objective: By comparing Osteoporotic Vertebral Compression Fracture(OVCF)Re-fracture after Over-extension Reduction percutaneous vertebroplasty(PVP)with traditional pillow therapy,we analyze the influence and causes of the incidence of New Vertebral Compression Fractures(NVCFs).And we study and discuss whether Preventive vertebroplasty can reduce the incidence of New Vertebral Compression Fractures for patients with vertebral compression fractures undergoing vertebroplasty and further explore the mechanism of New Vertebral Compression Fractures.Methods: We selected one hundred and eighty-three patients diagnosed with Osteoporotic Vertebral Compression Fracture and divided them into the surgical treatment group and the conservative treatment group by treatment.The surgical treatment group(ninety cases)received hyperextension reduction and percutaneous vertebroplasty,while the conservative treatment group(seventy-seven cases)received traditional pillow therapy.Before treatment and 3 days,6 months,12 months and 18 months after treatment,X-ray examination was used to measure the changes of kyphosis angle and anterior height of vertebral body.The interval from initial fracture to new fracture,the number of new fractures,the number of new fractured vertebral bodies and the distribution of new fractured vertebral body segments were observed respectively in the two groups of patients.The surgical treatment group needs to record whether there are complications such as the leakage of bone cement during the operation.Chi-square test was performed on the counting data and the measurement data was expressed in the form of standard deviation(X ±S).Carry out intra-group and inter-group T-tests.Results: Among the seventy-seven patients in the conservative treatment group,twenty patients(twenty-six percent)have new fractures in twenty-five vertebral bodies,ten vertebral bodies(forty percent)are adjacent vertebral bodies of the initial injured vertebral body and fifteen vertebral bodies(sixty percent)were non-adjacent vertebral bodies.The incidence of new fracture in conservative treatment group is twenty-six percent and the probability of adjacent vertebral fracture is forty percent.Among the ninety patients in the surgical treatment group,thirty-one patients(thirty-five percent)have new fractures in thirty-two vertebral bodies,fourteen vertebral bodies(forty-three percent)are adjacent vertebral bodies of the initial injured vertebral body and eighteen vertebral bodies(fifty-seven)were non-adjacent vertebral bodies.The incidence rate of new fractures in the surgical treatment group was thirty-five percent and the probability of adjacent vertebral fractures is forty-three point seven percent.There is no significant difference in the probability of new fracture between the two treatments(P is more than zero point zero five).The initial fractures of the two groups of patients are easy to occur in the thoracolumbar segment(T12 and L1 vertebral bodies).The new fractures in the conservative treatment group are easy to occur in T12 and L1 vertebral bodies and the new fractures in the surgical treatment group are easy to occur in L1 vertebral bodies.There was no significant difference in the distribution of new fracture sites between the two treatment methods(P is more than zero point zero five).Conclusions: Compared with non-adjacent vertebral bodies,adjacent vertebral bodies of injured vertebral bodies have no higher risk of re-fracture.Compared with non-adjacent vertebral bodies,adjacent vertebral bodies of injured vertebral bodies have no higher risk of re-fracture.Therefore,we still need to discuss whether to carry out preventive vertebroplasty for adjacent vertebrae.New vertebral fracture after vertebroplasty may be the natural course progression of osteoporosis,rather than the postoperative complications caused by operation.