Classified treatment of severe osteoporotic vertebral compression fracture by percutaneous kyphoplasty
10.3760/cma.j.issn.0254-9026.2014.11.012
- VernacularTitle:椎体后凸成形术对重度骨质疏松性椎体压缩骨折患者的分型治疗
- Author:
Jiye LU
;
Guoqiang JIANG
;
Bin LU
;
Chaolu SHI
;
Kefeng LUO
;
Bing YUE
- Publication Type:Journal Article
- Keywords:
Osteoporosis;
Fracture,compression;
Vertebroplasty
- From:
Chinese Journal of Geriatrics
2014;33(11):1194-1197
- CountryChina
- Language:Chinese
-
Abstract:
Objective To retrospectively review the clinical experience of percutaneous kyphoplasty (PKP) in the treatment of severe osteoporotic vertebral compression fracture (OVCF) during 10 years,and to propose a new classified treatment for OVCF.Methods 1200 patients with osteoporotic thoracolumbar vertebral compression fracture underwent percutaneous kyphoplasty from Aug.2003 to Aug.2013.There were 62 severe patients (5.2%,81 vertebraes),aged from 69 to 95 years (average 76.5 years),with 66.7% to 78.9% (average 71.3%) of vertebral body compression.Patients were followed up for 12 to 120 months (average 78 months).According to the preoperative imaging data,the fractures were classified into four types:simple type,pseudarthrosis type,cavern type,progressive type.Individualized PKP was performed on each patient.Results All the patients tolerated procedure well.The visual analogue scale (VAS) was reduced from (7.2± 2.1)preoperatively to (2.5±1.7) 3 days after PKP(t=13.197,P<0.01).The Medical Outcomes Study (MOS) 36-Item Short Form Health Survey (SF-36) scales was improved from (29.5±8.2) to (46.5±9.9) 3 days after surgery(t=22.884,P<0.01).Most patients were satisfied with the efficacy.The anterior height of vertebral body was increased from (14.21±2.44) mm preoperatively to (19.28 ±4.37) mm 3 days after surgery(t=9.108,P<0.01).The Cobb angle were decreased from (16.45 ± ±5.37)° to (9.41±4.13)° 3 days after surgery(t=9.355,P<0.01).The height of vertebrae was lost and the kyphosis angle aggravated with the follow-up time.New vertebral fractures were found in 21 patients (21/62,33.9%) at the last follow-up.Conclusions The preoperative accurate classification of severe osteoporosis vertebral compression fracture and individualized PKP can raise the successful operation rate and reduce the incidences of complications.