Clinical study of percutaneous kyphoplasty in treatment of vertebral compression fracture in elderly patients / 中国基层医药

ABSTRACT

Objective To explore the clinical application of PKP in treatment of VCF in elderly patients . Methods 77 elderly patients with VCF were divided randomly into PVP group unilateral PKP group and bilateral PKP group by method of random number table .Preoperative and postoperative VAS scores , vertebral height , Cobb′s angles,operative duration and incidence of bone cement leakage were observed and compared before and after opera -tions in different groups .Results VAS score after 6 days and 6 weeks after operation decreased significantly in all patients.In PVP group,VAS improved form (8.47 ±1.42) to (2.15 ±0.83) at 6 days after treatment ( t=5.24) and to (2.89 ±0.82) at 6 weeks after treatment(t=4.82);In unilateral PKP group,VAS improved form (8.52 ± 1.20) to (2.11 ±0.78) at 6 days after treatment(t=5.93) and to (2.04 ±0.75) at 6 weeks after treatment (t=2.05);In bilateral PKP group,VAS improved form (8.44 ±1.24) to (2.14 ±0.82) at 6 days after treatment (t=6.29) and to (2.02 ±0.71) at 6 weeks after treatment (t=3.14),(all P<0.05);VAS score after 6 weeks in PVP group was significantly higher than that in other two groups ( tunilateral PKP =5.19, tbilateral PKP =6.82, P <0.05);vertebral height and Cobb′s angle were improved significantly after operations in all patients ,In PVP group, vertebral leading edge height improved from (18.19 ±1.32)mm to (20.17 ±1.66)mm(t=7.53),vertebral back edge height improved from (23.62 ±0.71)mm to (24.07 ±0.60)mm (t=6.18),Cobb′s angle improved from (10.26 ±1.60) degrees to (5.40 ±0.92) degrees (t=4.92)(all P<0.05);In unilateral PKP group,vertebral leading edge height improved from (19.17 ±1.12)mm to (21.60 ±1.02)mm(t=5.51),vertebral back edge height improved from (22.31 ±0.92)mm to(24.98 ±0.30)mm(t=6.25),Cobb′s angle improved from (10.55 ±1.48) degrees to(5.28 ±0.43)degrees(t=5.44)(all P<0.05);In bilateral PKP group,vertebral leading edge height im-proved from (18.63 ±1.24)mm to (20.46 ±1.11)mm(t =4.28),vertebral back edge height improved from (24.61 ±0.40)mm to (25.09 ±0.43)mm(t =9.62),Cobb′s angle improved from (10.72 ±1.52)degrees to (55.32 ±0.48)degrees(t=8.36)(all P<0.05).Operative duration was significantly longer in bilateral PKP group which was (57.54 ±12.75)min than that in PVP group which was (40.39 ±11.40)min (t=7.10),or unilateral group which was (38.18 ±15.31)min (t=5.42,all P<0.05);incidence of bone cement leakage was significantly higher in PVP group(64.00%) than in bilateral(19.23%,χ2 =10.59)/unilateral groups(23.08%,χ2 =8.66)(all P<0.05).Conclusion Unilateral PKP is a proper method in treatment of VCF in elderly patients .