| Objective The purpose of this study was to compare the clinical efficacy of percutaneous vertebroplasty in the treatment of fresh and old osteoporotic compression fractures.Methods A total of 76 patients with osteoporotic vertebral compression fracture(Osteoporosis vertebra compressed fracture,OVCF)who were admitted to Subei Hospital of Jiangsu Province from September 2017 to January 2019 and finally selected percutaneous vertebroplasty(Percutaneous vertebroplasty,PVP)were analyzed retrospectively.All patients were followed up regularly for 12 to 15 months with an average of(13.63±0.98)months.The patients were instructed to take anti-osteoporotic drugs to treat osteoporosis.All patients were divided into two groups according to the time of fracture:fresh fracture group and old fracture group.There were 46 patients in the fresh fracture group,including 18 male patients and 28 female patients,aged from 49 to 78 years old,with an average age of(61.89±6.55)years,and BMD-3.15±0.42 SD.And there were 30 patients in the old fracture group,including 12 male patients and 18 female patients,aged from 51 to 74 years old,with an average age of(62.80±5.57)years,and BMD-3.11 ±0.37SD.Percutaneous vertebroplasty was performed in both groups.The general and preoperative data of all patients were collected,including age and sex,bone mineral density T value and surgical segment.Operation-related data include:hospital stay and operation time,intraoperative blood loss and bone cement injection.Clinical evaluation data:Visual analogue score(VAS)was used to evaluate pain relief and Oswestry disability index(ODI)was used to evaluate the functional recovery of patients before operation,1 day,3 months and 12 months after operation.Imaging index:the height of vertebral body and the angle of kyphosis were measured and recorded before and after operation.Complications:the occurrence of incision infection,nerve injury,bone cement leakage,adjacent vertebral fracture,deep venous thrombosis and embolism of lower extremities were recorded.For the measurement data,the data with normal distribution were compared between the two groups by independent sample t-test,and the SNK method was used at different time points in the group.The counting data(sex,operative segment,postoperative complications)were tested by Chi 2 test.The difference was statistically significant(P<0,05).The relevant indexes were obtained to compare the clinical efficacy of percutaneous vertebroplasty in the treatment of fresh osteoporotic compression fracture and old fracture.Result The operations of all the patients in this study were completed successfully.The patient recovered well after operation,and there were no other complications such as incision infection,spinal cord compression and nerve injury,lower limb deep venous thrombosis and embolism,cardio-cerebrovascular disease,death and so on.There was no significant difference in preoperative basic data,VAS score and ODI index between the two groups(P>0.05).There was no significant difference in operation time,intraoperative blood loss,bone cement injection and hospital stay between the two groups(P>0.05).The postoperative VAS score and ODI index of the two groups were significantly improved compared with those before operation(P<0.05),and there was no significant difference between the two groups at the same time point(P>0.05).The vertebral height and kyphosis angle were measured on the X-ray film before and after operation.The vertebral height and kyphosis angle in the fresh group were significantly better than those before operation(P<0.05),but there was no significant difference in the old group(P>0.05).Bone cement leakage occurred in 8 patients(17.36%)in the fresh fracture group,including 5 cases of perivertebral leakage,3 cases of intervertebral disc leakage,and 2 cases(4.35%)of adjacent vertebral body fracture.In the old fracture group,5 patients(16.67%)had bone cement leakage,all around the vertebral body,and 1 patient(3.33%)had fracture of the adjacent vertebral body.No symptoms of spinal cord or nerve compression caused by bone cement leakage were found in all patients.There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion In the treatment of osteoporotic vertebral compression fractures in the elderly,percutaneous vertebroplasty can achieve good clinical results in relieving pain in both fresh and old fractures.Compared with the old fracture group,the vertebral height and kyphosis angle of fresh fracture patients were better improved after receiving PVP.Therefore,for patients with osteoporotic vertebral fracture,if there are no surgical contraindications,vertebroplasty as soon as possible can achieve better clinical efficacy and quality of life.In general,vertebroplasty is a safe and reliable surgical method. |
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