Comparative Analysis Of PVP And PKP In The Treatment Of High Thoracic Metastatic

Objective: Comparatively analyze the efficacy of percutaneous vertebroplasty(PVP)and percutaneous kyphoplasty(PKP)in the treatment of high thoracic spine metastases.Methods: Retrospectively analysis of 32 patients with high thoracic spine(T1~T6)metastases treat by PVP or PKP surgery in theinterwention of the First Affiliated Hospital of China Medical University from January 2010 to January 2021 was conducted,and a total of 37 vertebrae were operated on,including19 PKP and 13 PVP.There are 20 surgical vertebrae in the PKP group,including 2 T2 vertebral bodies,4 T4 vertebral bodies,5 T5 vertebral bodies,and 9 T6 vertebral bodies.There are 17 surgical vertebrae in the PVP group,including 2 T1 vertebral bodies,4 T2 vertebral bodies,3 T3 vertebral bodies,3 T4 vertebral bodies,3 T5 vertebral bodies,and 2 T6 vertebral bodies.There were 6 male patients and 7 female patients in the PVP group,with an average age of 62.68±6.18 years old,in the PKP group,there were 10 male patients and 9 female patients,with an average age of 61.69±5.69 years old.Through statistics and comparison the functional status score standards(Karnofsky,KPS),visual analogue scale(VAS),vertebral height,cobb angle,bone cement injection volume and penetration before and after operation,comparative analysis of the curative effect of two kinds of operation.Results: Among 32 patients,18 patients underwent unilateral vertebral puncture(all were left puncture)and 14 patients underwent bilateral vertebral puncture.The amount of bone cement injected in the PKP group was 2.90±1.77 ml,and the amount of bone cement injected in the PVP group was 2.26±0.94 ml.In this study,in the 17 vertebrae treated with PVP,there were 2 cases of slight leakage of bone cement to the posterior edge of the vertebral body during the operation(the leakage rate was 12%);but in the 20 vertebrae treated with PKP,there was no bone cement leakage during the operation,and 5 cases were combined with particles during the PKP operation.After the operation,the pain of the vertebral body was relieved,the wounds healed well,and there was no infection.After 24 hours,he can carry out activities under the protection of the brace,and his activity ability is obviously improved.The results of statistical analysis show that,before operation,there was no statistical significancee in VAS and KPS score between the PVP group and PKP group(P>0.05),but 1 month,3 months,half year and one year after surgery,the VAS and KPS scores of PVP group and PKP group were significantly different(P<005).Before surgery,there was no statistical significance in vertebral height between PVP group and PKP group(P>005),but after surgery,compared to the the PVP group,the height of vertebral body and cobb angle in the PKP group recovered better(P<0.05).And the amount of bone cement and the permeability of bone cement in the PKP group were better than those in the PVP group(P<0.05).Among them,42 cases of the vertebral body all with degrees of pain history before surgery.32 patients underwent complete 3D-CT and MRI examinations and accepted PVP or PKP surgery.Conclusion: PVP and PKP both have good curative effect on spinal metastasis and can relieve the pain of patients and improve event function.However,PKP is more effective in improving the pahtological vertebral body height,correcting kyphosis,increasing the amount of bone cement and reducing bone cement leakage.