Curative effect of percutaneous kyphoplasty for treatment of vertebral compression fractures in perimenopausal women / 中华创伤杂志

ABSTRACT

Objective To investigate the clinical outcomes of percutaneous kyphoplasty (PKP) for treatment of vertebral compression fractures in perimenpausal women.Methods A total of 53 perimenopausal patients (70 vertebrae) undergone PKP for vertebral compression fractures from January 2007 to May 2014 were analyzed retrospectively by case-control study.Thirty-six patients had single vertebral fractures and 17 two-level vertebral fractures.The fracture segments included 5 T11 vertebrae,14 T12 vertebrae,30 L1 vertebrae,12 L2 vertebrae and 9 L3 vertebrae.Ratio of vertebral compression was 10％-30％.According to treatment difference,the patients were divided into PKP group and non-operation group.In PKP group,there were 30 patients with age range of 44-54 years (mean,51.0 years),and the fracture segments included 13 T11 vertebrae,11 T12 vertebrae,17 L1 vertebrae,7 L2 vertebrae,3 L3 vertebrae.In non-operation group,there were 23 patients with age range of 44-54 years (mean,50.5 years),and the fracture segments included 2 T11 vertebrae,3 T12 vertebrae,13 L1 vertebrae,5 L2 vertebrae,6 L3 vertebrae.Visual analogue scale (VAS),Oswesty disability index (ODI),vertebral compression rate,Cobb angle and bone mineral density change were compared preoperatively,2 weeks,6 months and 3 years after operation.Results All patients were followed up for 6-36 months.VAS and ODI were improved compared with preoperative status in two groups at 2 weeks,6 months and 3 years (P ＜ 0.01).VAS and ODI in PKP group were significantly decreased at 2 weeks and 6 months compared with non-operation group (P ＜ 0.01).The Cobb angle and vertebral compression rate in non-operation group were improved at 6 months compared with those in preoperative status (P ＜ 0.05),and a consistent increase was noted at 3 years,but the difference was not statistically significant (P ＞ 0.05).The Cobb angle and vertebral compression rate in PKP group were reduced at 6 months compared with preoperative status (P ＜ 0.05),and an increase was noted at 3 years,but the difference was not statistically significant (P ＞ 0.05).The Cobb angle and vertebral compression rate in PKP group did not increase at 6 months and 3 years,but they had significant increase in non-operation group (P ＜ 0.05).The body mass index in non-operation group decreased at different degrees at 6 months and 3 years,compared with preoperative status (P ＜ 0.05),while the body mass index reduction in PKP group had no statistically significant difference (P ＞ 0.05).The body mass index reduction in PKP group was less than that in non-operation group at 3 years (P ＜0.01).The body mass index reduction in PKP group was slow and had no statistically significant difference compared with preoperative status (P ＞ 0.05).The body mass index reduction in non-operation group was fast and had significant decrease compared with preoperative status (P ＜ 0.05).Conclusion PKP can relieve pain for vertebral compression fractures in perimenopausal women in short term and long term,and PKP can also improve spinal kyphosis and prohibit the decline of bone mineral density.