| Objective:Compare the treatment effect and related complications of PVP and PKP on patient with OVCF by Prospective study and to know about which method is more advantageous so as to give further instructions on clinical work.Methods:From April 2016 to June 2017,there were 126 patients with osteoporotic vertebral compression fractures(OVCF)admitted to Municipal Hospital of Heze.105 patients agreed to perform minimally invasive surgery,with the help of random number generator,random numbers between 1 and 100 were generated,the odd number was chosen for Percutaneous vertebroplasty(PVP),the even number was chosen for Percutaneous kyphoplasty(PKP).Among them,56 patients were selected for PVP surgery and 49 patients were selected for PKP surgery.105 patients were followed up at 1 month after surgery,3 months after surgery,6 months after surgery,and 1 year after surgery.Of these,93 were patients who underwent full follow-up,51 in the PVP surgery group,and 42 in the PKP surgery group.The sample was selected from the above 93 people,30 in the PVP surgery group,and 30 in the PKP surgery group.The data of the two group is measured by X±S.In the group that accepts PVP treatment,there are 6 male patients,24 female patients and the age is from 61-87 with the average age of 67.17±6.43.Their average bone density is-3.21±0.48.Among them,25 patients have single disease vertebra;4 patients have double disease vertebra and 1 patient has triple disease vertebra.The average disease vertebra number is 1.20±0.48.There are total 16 disease thoracic vertebra,20 disease lumbar vertebra and the single disease vertebra is filled with 4.01 ± 1.12ml bone cement.In the group that accepts PKP treatment,there are 5 male patients,25 female patients and the age is from 60-88 with the average age of 68.09±6.82.The average bone density is-3.28±0.51.There are 26 patents with single disease vertebra,3 patients with double disease vertebra and 1 patient with triple disease vertebra.The average disease vertebra number is 1.17±0.45.There are total 14 disease thoracic vertebra,21 disease lumbar vertebra and the single disease vertebra is filled with 4.21±1.09 ml bone cement.Based on the SPSS22.0 statistics software,the comparison of measurement data is done based on t test and the comparison of enumeration data is conducted based on chi-square test.It is set that if P is smaller than 0.05,the data difference has statistical meaning.Through statistical analysis,General data of two group patients,the difference of gender,age,osteoporosis degree,disease vertebra number,disease vertebra location and bone cement filling amount of the patients of two groups does not have statistical meaning(P>0.05).Collect all the patients' VAS score,vertebral height and Cobb angle of diseasedvertebrae at the time points of before the operation,2 days after the operation,1 month after the operation,3 months after the operation,6 months after the operation and 1 year after the operation.Meanwhile,record the number of disease vertebra with bone cement leakage of the two groups and the number of patients with adjacent vertebral re-fracture after operation of the two groups.Compare the VAS score,disease vertebral height and Cobb angle information collected before operation and 2 days after the operation within the group,compare the disease vertebral height and Cobb angle information collected 2 days after the operation and 1 year after the operation,within the group.And then compare the VAS score,disease vertebral height and Cobb angle information collected at different times points between the patients of two groups.Compare the number of disease vertebra with bone cement leakage,and the patient number with adjacent vertebral re-fracture after operation between the two groups.Result:The sample patient's VAS score is obviously decreased before the operation and 2 days after the operation and there is a big difference within the group which has statistical meaning(P<0.05).The VAS score collected at before the operation and different time points after the operation from the two groups does not have statistical meaning(P>0.05).The disease vertebra height and Cobb angle of the patients from the two group are obviously improved before the operation and 2 days after the operation,and the difference within the group has statistical meaning(P<0.05).Before the operation,the disease vertebra height and Cobb angle of the patients from the two group are different but the difference does not have statistical meaning(P>0.05).After the operation,the disease vertebra height and Cobb angle data is collected at different time points after the operation,and the difference between two groups have statistical meaning(P<0.05).The disease vertebra height and Cobb angle of the patients from the two group have no significant difference 2 days after the operation and 1 year after the operation.The bone cement leakage rate of PVP group is higher than that of PKP group and the difference between the two groups has statistical meaning(P<0.05).The rate of adjacent vertebral re-fracture after operation of the two groups is different but the difference does not have statistical meaning(P>0.05).Conclusion:Both PVP and PKP operation can effectively relieve pain feeling and the relief degree of these two methods does not have big difference within short time.The OVCF patients of the two groups all have height loss in anterior and middle columns of diseased vertebra but the height loss in anterior column is more obvious.The two operation methods can both recover the disease vertebra height in some degree and can reduce the Cobb angle but the effect of PKP is better than PVP.The disease vertebra height will not collapse again in a short time after the operation with these two methods.The cement leakage may occur in both operations,but the risk in PKP is relatively small.Under the low-energy or non-violence situation,after the operation with these two methods,the risk of re-fracture of adjacent vertebral bodies all exists within short time,and the risk caused by the two methods does not have significant difference. |
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