Clinical effect of percutaneous kyphoplasty in treating old osteoporotic vertebral compression fractures combined with intravertebral clefts / 中华老年医学杂志

ABSTRACT

Objective To evaluate the effect of percutaneous kyphoplasty (PKP) in the treatment of old osteoporotic vertebral compression fractures with intravertebral clefts.Methods 25 patients (25 vertebrae) suffering from old OVCF with vacuum phenomenon were treated with PKP.There were 8 males and 17 females with an average age of 72.7 years (range,64-84 years) and with an average duration of 7.8 months (range,6-24 months).The height of anterior column and the posterior convex Cobb angle of injured spine were measured on the lateral X-ray film in standing position at pre-operation and post-operation.Clinical symptoms were evaluated by visual analogue scale (VAS).The amount of bleeding and bone cement and complications were recorded.Results All of 25 operations were performed successfully without severe complications.Cement leakage occurred in 5 cases (20％),including 3 cases at the anterior vertebral edge and 2 cases at the lateral vertebra.The surgery time for each vertebra was 35～60 min (mean 42 min),and bone cement volume for each vertebra was 2.0～5.5 ml (mean 3.1 ml).25 patients were followed up for 12 months (range,6-15 months).The VAS score was decreased from (7.44 ± 1.0) preoperatively to (2.36 ± 0.8) day 3 postoperatively and to (2.12 ± 0.7) the last follow-up; the Cobb' s angle was improved from (28.28±3.76) to (23.28±3.76) and (24.32±3.94) respectively; and the anterior vertebral height was increased from (22.48±4.38) mm to (25.80±4.89) mm and (25.24±4.84) mm respectively.There were significant differences in VAS,Cobb's angle,and anterior vertebral height between prre-and post-operation (F=297.84,12.39 and 3.56,P＜0.001 or 0.05),but there were no significant differences in these indicators between day 3 postoperatively and the last follow-up (all P ＞ 0.05).Conclusions PKP is effective in the treatment of old osteoporotic vertebral compression fractures combined with intravertebral clefts.It can relieve pain rapidly and effectively,correct kyphosis,and prevent vertebra collapse.