Comparison on vesselplasty and percutaneous kyphoplasty in treatment of osteoporotic thoracolumbar vertebral fractures in elderly patients / 中华创伤杂志

ABSTRACT

Objective To compare the clinical effects of vesselplasty and percutaneous kyphoplasty in the treatment of osteoporotic thoracolumbar vertebral fracture in the elderly.Methods A retrospective case control study was conducted to analyze 52 cases of OVCFs treated from August 2013 to May 2015.According to treatment method,the patients were assigned to vesselplasty (Group A) and percutaneous kyphoplasty (Group B).Group A (25 cases,38 vertebrae) included 11 males and 14 females,aged (63.6 ±8.3)years (range,60-89 years).In Group A,there were nine cases of T11,10 T12,13 L1,and six L2.Group B (27 cases,41 vertebrae) included 10 males and 17 females,aged (64.1 ±9.6)years (range,63-87 years).In Group B,there were seven cases of T11,13 T12,12 L1,and nine L2.The bone cement leakage before operation,after operation,and at the last follow-up were recorded.The operation time,average fluoroscopy frequency,visual analog score (VAS),vertebral reduction height,Cobb angle,and Oswestry disability index (ODI) changes were compared between two groups.Results All patients were followed up for 6-18 months (mean,12 months).The operation time was (29.3 ± 4.1)minutes in Group A and (35.7 ± 5.2) minutes in Group B (P ＜ 0.05).The number of fluoroscopy was (9.3 ± 1.5) times in Group A and (13.1 ±3.7)times in Group B (P ＜0.05).The VAS at the last follow up was (1.3 ±0.3) points in Group A and (1.4 ± 0.3) points in Group B;the ODI at the last follow up was 32.5 ± 6.7in Group A and 30.5 ± 5.3 in Group B;the injured vertebral height at the last follow up was (85.3 ±9.7)％ in Group A and (82.7 ±10.4)％ in Group B;the Cobb angle at the last follow up was (11.3 ±5.3) ° in Group A and (12.7 ± 6.1) ° in Group B.VAS,vertebral reduction height,and Cobb angle were all improved significantly compared with those before operation (P ＜ 0.05),but there was no significant difference between two groups (P ＞0.05).The leakage rate was 3％ in Group A and 26％ in Group B (P ＜ O.05).Conclusion Both vesselplasty and percutaneous kyphoplasty can quickly relieve the pain and effectively restore the height of injured vertebra.But vesselplasty can reduce bone cement leakage more effectively,thus being a better treatment for osteoporotic thoracolumbar vertebral fracture in the elderly.