| Objectives To explore the application of pedicle screw fixation(PSF)combined with percutaneous vertebroplasty(PVP)and percutaneous kyphoplasty(PKP),The efficacy of PKP on osteoporotic vertebral compression fractures in solving immediate and long-term low back pain symptoms is compared,which provides a choice direction for the treatment of osteoporotic vertebral compression fractures.Methods From October 2018 to October 2019,61 patients with osteoporotic thoracolumbar compression fracture at single vertebral level were selected and divided into experimental group(group A)and control group(group B).Among them,33 patients in the experimental group were treated with PSF combined with PVP.Twenty-eight patients in the control group were treated with PKP.Statistical analysis of the differences between the two groups before,3 days after and 1 year after operation in the percentage of the height of the anterior edge of the injured vertebral body,Cobb’s angle of kyphosis,visual analogue score,VAS of pain,and ODI index of low back pain,so as to evaluate the immediate and long-term effects of the two surgical methods on senile osteoporotic thoracolumbar compression fractures.Results The operation time was(110.6±9.8)min in group A and(40.7±5.1)min;in group B;The postoperative bed rest time was(9.0±1.5)d in group A and(3.3±1.1)d in group B;The amount of operative bleeding was(92.4±20.2)m L in group a and(12.8±3.8)m L in group B.The results showed that group A had longer operation time(P<0.001),longer postoperative bed rest time(P<0.001)and more intraoperative blood loss(P<0.001)than group B.After 3 days and 1 year follow-up,it was found that the percentage of anterior edge height,Cobb’s angle,VAS score and ODI score of the two methods were improved compared with those before operation.In the comparison between the two groups,there was no significant difference in Cobb’s angle and VAS score 3 days after operation(P>0.05),but there was significant difference in vertebral front height ratio and ODI score 3 days after operation(P<0.001).One-year follow-up showed that the percentage of anterior edge height,Cobb’s angle of kyphosis,VAS score and ODI score of injured vertebrae were [(81.8±4.6)%;(16.0±4.1)°;(2.7±1.3)points;(24.8 3.8)%] was superior to the control group [(73.8±3.8)%;(20.0±5.1)°;(3.4±1.5)points;(27.7±5.6)%](P<0.05)。Conclusions Pedicle screw fixation combined with vertebroplasty and kyphoplasty can make the vertebral body obtain immediate stability,improve the quality of life,and greatly reduce the probability of complications caused by conservative treatment.However,the combined operation has better advantages in restoring vertebral height,improving kyphosis and reducing the incidence of chronic low back pain.Compared with the combined operation,kyphosis alone has the advantages of lower operation cost,smaller incision,less bleeding and shorter time in bed.However,combined operation is still an effective choice for patients with osteoporotic vertebral compression fracture.Figure 3;Table 6;Reference 102... |
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