Observation Of The Curative Effect Of Different Puncture Routes In PVP After OVCF Orthopedic Manipulation

OBJECTIVE: To compare the clinical efficacy and safety of Osteoporatic vertebral compression fracture(OVCF)in different puncture paths during percutaneous vertebroplasty(PVP).METHODS: Patients with osteoporotic vertebral compression fractures who underwent PVP between January 20 and December 2018 were enrolled.Of these,30 were treated with modified puncture path(group A)and 30 with classic puncture path(Group B).The visual analogue score(VAS)score,0swestry disability index(ODI)index,vertebral height recovery rate,Cobb angle change,and bone cement dispersion were compared between the two groups.As well as intraoperative bone cement leakage rate,and improved Mac Nab assessment criteria as a standard of efficacy evaluation.RESULTS: The two groups were not statistically significant(P>0.05).The VAS score of group A decreased from preoperative(7.5 ± 0.973)to postoperative(2.20 ± 0.805);ODI index decreased from preoperative(34.433 ± 2.045)to postoperative(12.566 ± 1.524);vertebral height recovery rate The latter was(38.914 ± 10.2);the preoperative Cobb angle(20.3 ± 3.097)was reduced to postoperative(5.733 ± 1.484);the postoperative cement dispersion rate was(80%).The VAS score of group B decreased from preoperative(7.5 ± 0.90)to postoperative(2.933 ± 0.944);ODI index decreased from preoperative(33.633 ± 1.809)to postoperative(14.166 ± 1.62);vertebral height recovery rate The latter was(34.658 ±9.79);the preoperative Cobb angle(20.166 ± 2.81)was reduced to postoperative(5.933 ± 1.552);the postoperative cement dispersion rate was(56%).There were significant differences between the two groups before and after the VAS score,ODI index,vertebral height recovery rate,Cobb angle,statistically significant(P <0.05),and postoperative VAS score and ODI index comparison,There was statistical significance in both groups,but there was no significant difference between the two groups in the vertebral height recovery rate and Cobb angle(P>0.05).There were differences in postoperative cement dispersion rate between the two groups.Statistical significance(P <0.05).There were 3 cases of cement leakage in group A,2 of which were located in vertebral venous plexus and 1 in front of vertebral body;5 cases of bone cement leakage occurred in group B,and3 cases were located in vertebral venous plexus,1 The cases were located in the intervertebral disc,and 1 case was located in front of the vertebral body.All patients had no neurological symptoms,signs and embolism of important organs.The incidence of cement leakage in the two groups was statistically significant(P<0.05).The excellent and good rate after treatment in the two groups: the excellent and good rate of group A: 80%,and the group B: 60%,the difference was statistically significant(P<0.05).Conclusion: Classical puncture path and modified puncture path for percutaneous vertebroplasty can significantly alleviate the pain caused by osteoporotic thoracolumbar vertebral compression fracture,improve life and work ability,and restore the shape of injured vertebrae,but the improved puncture path is It has advantages in improving symptoms and signs,and the cement dispersion is better than the classic puncture path,while the cement leakage rate is lower than the classic puncture path.