K-Z Hu1, S-C Chen, L Xu. 1. Department of Orthopedics, Shanxian Central Hospital, Shanxian, China. 2402595111@qq.com.
Abstract
OBJECTIVE:Osteoporotic vertebral compression fractures (OVCFs) are common diseases in elderly patients and can cause serious thoracolumbar compression fractures. For patients with such fractures, conservative treatment, nail-stick fixation, percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) can be selected as treatment methods. In this study, we aimed to compare the clinical efficacy of PKP and PVP in the treatment of osteoporotic thoracolumbar vertebral compression fractures. PATIENTS AND METHODS: One hundred and sixty-one patients with single-stage osteoporotic vertebral compression fracture in thoracolumbar were enrolled and divided into two groups, percutaneous balloon kyphoplasty (PKP group) and percutaneous vertebroplasty (PVP group). The subjects were selected from patients who were once treated in our hospital from January 2012 to December 2015. There were 91 cases in PKP group and 70 cases in PVP group. The hospitalization time, operation-related index (including blood loss, bone cement injection, surgical time and number of intraoperative fluoroscopy), bedrest time, visual analog pain score (VAS), Cobb's angle, vertebral anterior height, Oswestry Disability Index (ODI) dysfunction index and quality of life score were compared to evaluate the clinical effects of the two treatment methods. RESULTS: There were significant differences in hospitalization time, operation-related index (including blood loss, bone cement injection, operation time, number of intraoperative fluoroscopies) and bed rest time between the two groups. Compared with the patients in PVP group, patients of PKP group had less hospital stay (p<0.001), less time in bed (p<0.05) and less intraoperative blood loss (p<0.05). In addition, the number of times we used intraoperative fluoroscopy was significantly different between the two groups (p<0.001). However, the operation time of PKP group was longer than that of PVP group, and the amount of intraoperative cement injection was more than that of PVP group (p<0.05). After treatment, VAS scores in both groups were dramatically decreased, of which the scores in PKP group were markedly lower than that in PVP group and the difference was statistically significant (p<0.05). The changes of Cobb's angle, the height of anterior vertebral body and ODI scores in PKP group were noticeably better than PVP group (p<0.05). There were 5 cases occurring intraoperative cement leakage in PKP group and 12 cases in PVP group, indicating that the former is relatively better (p<0.001). However, no significant difference was found between the two groups in the occurrence of secondary vertebral fractures at 1 month, 3 months, 6 months and 12 months after treatment (p>0.05). CONCLUSIONS: The clinical effects of both PKP and PVP in the treatment of osteoporotic vertebral compression fractures are good, of which the reductive and analgesic effect of PKP is superior to that of PVP and the former has less leakage of cement, higher safety and fewer complications.
RCT Entities:
OBJECTIVE:Osteoporotic vertebral compression fractures (OVCFs) are common diseases in elderly patients and can cause serious thoracolumbar compression fractures. For patients with such fractures, conservative treatment, nail-stick fixation, percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) can be selected as treatment methods. In this study, we aimed to compare the clinical efficacy of PKP and PVP in the treatment of osteoporotic thoracolumbar vertebral compression fractures. PATIENTS AND METHODS: One hundred and sixty-one patients with single-stage osteoporotic vertebral compression fracture in thoracolumbar were enrolled and divided into two groups, percutaneous balloon kyphoplasty (PKP group) and percutaneous vertebroplasty (PVP group). The subjects were selected from patients who were once treated in our hospital from January 2012 to December 2015. There were 91 cases in PKP group and 70 cases in PVP group. The hospitalization time, operation-related index (including blood loss, bone cement injection, surgical time and number of intraoperative fluoroscopy), bedrest time, visual analog pain score (VAS), Cobb's angle, vertebral anterior height, Oswestry Disability Index (ODI) dysfunction index and quality of life score were compared to evaluate the clinical effects of the two treatment methods. RESULTS: There were significant differences in hospitalization time, operation-related index (including blood loss, bone cement injection, operation time, number of intraoperative fluoroscopies) and bed rest time between the two groups. Compared with the patients in PVP group, patients of PKP group had less hospital stay (p<0.001), less time in bed (p<0.05) and less intraoperative blood loss (p<0.05). In addition, the number of times we used intraoperative fluoroscopy was significantly different between the two groups (p<0.001). However, the operation time of PKP group was longer than that of PVP group, and the amount of intraoperative cement injection was more than that of PVP group (p<0.05). After treatment, VAS scores in both groups were dramatically decreased, of which the scores in PKP group were markedly lower than that in PVP group and the difference was statistically significant (p<0.05). The changes of Cobb's angle, the height of anterior vertebral body and ODI scores in PKP group were noticeably better than PVP group (p<0.05). There were 5 cases occurring intraoperative cement leakage in PKP group and 12 cases in PVP group, indicating that the former is relatively better (p<0.001). However, no significant difference was found between the two groups in the occurrence of secondary vertebral fractures at 1 month, 3 months, 6 months and 12 months after treatment (p>0.05). CONCLUSIONS: The clinical effects of both PKP and PVP in the treatment of osteoporotic vertebral compression fractures are good, of which the reductive and analgesic effect of PKP is superior to that of PVP and the former has less leakage of cement, higher safety and fewer complications.