Clinical Effects Analysis Of Bone Cement Distribution In Percutaneous Kyphoplasty For Osteoporotic Vertebral Compression Fracture

ObjectiveTo compare short-term and medium-term clinical effects between two different bone cement distributions of osteoporotic vertebral compression fracture(OVCF)patients who treated with percutaneous kyphoplasty(PKP).MethodsWe collected 292 patients from January 2015 to July 2017 diagnosed as OVCF and treated with PKP.There were 52 males,240 females,with an average age of(69.37±9.39)years old which range from 52 to 95 years old.According to the postsurgical X-ray images,we divided bone cement distributions of patients into two groups:?Typing 'H'(group H,189 cases):bone cement forms two lumps in the vertebral body,connected without or with little bone cement.The group H has 39 males and 150 females,aged(68.39±8.39)years old.?Typing 'O'(group O,103 cases):the bone cement forms a whole lump in the vertebral body,no separation or loss in the middle of bone cement.The group O has 13 males and 90 females,aged(69.59±9.13)years old.General anesthesia was used to make the patient prone to operate.We injected bone cement into the vertebral body through unilateral or bilateral transpedicular approach,then expanded the fractured vertebra with a balloon,and injected bone cement into the vertebral body.We recorded bone mineral density,operative approach,intraoperative blood loss,operation time,the amount of bone cement injection,bone cement leakage rate.The visual analogue scales(VAS),the local kyphosis Cobb angle,the relative height of the front edge and the middle of the fractured vertebra were measured before operation,two days and one year after operation.ResultsThe follow-up time of 292 patients in this group was more than 1 year.There was no statistically significant difference between two groups in bone mineral density,intraoperative blood loss,operation time,bone cement leakage rate(P>0.05).Group O has more unilateral approach cases than group H(P<0.001)and group H injected more bone cement than group O(P<0.001).The VAS scores compared within each group were statistically significant(P<0.05)and 1 year after surgery of group H was lower than 2 days after surgery.When compared between the two groups,the VAS score 1 year after surgery of group H was lower than group O(P<0.001).There was no statistically significant difference in VAS scores before and 2 days after surgery(P>0.05).Both in two groups,there was statistically significant difference in Cobb angle between 2 days and 1 year after surgery(P<0.05),but no statistically significant difference in Cobb Angle between the two groups(P>0.05).There were statistically significant differences in both groups in the relative height of the front edge and the middle of the injured vertebra(P<0.05),but no statistical differences were found between the two groups(P>0.05).ConclusionBoth types of bone cement distribution can achieve satisfactory clinical effects,while the typing 'H' bone cement distribution had a better short-term effect than typing 'O'.