Therapeutic Effect Of PVP And PKP On Osteoporotic Vertebral Compression Fractures With Posterior Wall Rupture

To evaluate the clinical efficacy of percutaneous vertebroplasty(PVP)and percutaneous kyphoplasty(PKP)in the treatment of osteoporotic vertebral compression fracture with posterior wall rupttre.Methods:A retrospective analysis of 114 patients with posterior wall raptured osteoporotic vertebral compression fractures who received intensive vertebral suigery fiom July 2013 to October 2017 in our hospital.Among them,61 patients underwent modified PVP and 53 underwent PKP.The baseline data from bone mineral density and age showed no significant difference between the two groups.The patients were followed up one day and one year after operation.VAS scores were recorded before,during and after each follow-up period The efficacy,dysfunction index,injection amount of bone cement,operation time,hospital stay,recovery of vertebral height,Cobb angle of injured vertebral body,leakage of bone cemait and incidence of fracture of adjacent vertebral body were recorded.The clinical efficacy and incidence of complications of the two operation methods were analyzed by statistical method.Result:All procedures were successfully completed and 114 patients were followed up.The VAS scores of the two groups wbetween ere significantly different from those before surgery(P<0.01).There was no significant difference in VAS scores between preoperative,postoperative,and 1-year follow-up between the two groups.There were significant differences in vertebral height and Cobb angle the pre-operation and the post operation in all the two groups(P<0.05),indicating that both procedures are effective in restoring vertebral height and Cobb angle of patients;However,there was a significant difference in vertebral height and Cobb angle recovery between the two groups(P<0.05),indicating that PKP is superior to PVP in terms of vertebral height recovery and improvement of Cobb angle.In the cases of bone cement leakage,there were 10 cases in the PVP group and 6 cases in the PKP group.There were no cases of cement leakage into the spinal canal in both groups,indicating that there were no significant difference in the incidence of cement leakage between the two groups(?2=0.605;P=0.437).There were 1 patient in the PVP group had adjacent segmental fractures,and the results in PKP group were 7,the difference was statistically significant(?2=4.719;P=0.041).It is indicated that patients after PKP are more likely to cause adjacent segmental vertebral fractures than patients after PVP.Conclusion:For patients with posterior wall ruptured osteoporotic vertebral compression fractures,modified PVP and PKP are both effective in the treatment effect.Modified PVP may be an effective method for intensive treatment of osteoporotic vertebral compression fractures with posterior wall rupture,it is also cost-effective and suitable for grassroots hospitals and patients with financial difficulties.