Correlation of short and medium-term efficacy and refracture rate with osteoporosis severity following percutaneous kyphoplasty of thoracolumbar fracture / 中华创伤杂志

ABSTRACT

Objective To examine the short-and middle-term efficacy and refracture rate in patients with thoracolumbar fracture having percutaneous kyphoplasty (PKP) and determine their correlation with the severity of osteoporosis.Methods A retrospective analysis was conducted on 247 patients with thoracolumbar fracture undergone PKP from January 2008 to February 2014.Mean age of the patients (94 males and 153 females) was 63.2 years (range,50-81 years).Ground-level falls occurred in 119 patients,traffic injuries in 72 patients and high falls in 56 patients.The patients were assigned to osteopenia group and osteoporosis group based on the preoperative bone mineral density.Visual analogue score (VAS),Roland-Morris disability survey scale (RDQ),vertebral compression rate,kyphotic Cobb angle and refracture rate were recorded before and after operation.Efficacy in correlation with the severity of osteoporosis was evaluated.Results Mean duration of follow-up was 24.3 months (range,18-36 months).Three days after operation,VAS descended from (7.7 ± 2.1) points to (4.3 ± 1.1) points in osteopenia group and from (7.7 ± 2.0) points to (4.2 ± 1.5) points in osteoporosis group (P ＜ 0.05);RDQ descended from (21.2 ± 1.5) points to (10.4 ± 2.5) points in osteopenia group and from (20.8 ± 1.9) points to (11.2 ± 1.7) points in osteoporosis group (P ＜ 0.05);rate of vertebral body compression descended from (42.2 ± 10.5) ％ to (3.2 ± 0.5) ％ in osteopenia group and from (46.2 ± 12.7) ％ to (2.9 ± 0.8) ％ in osteoporosis group (P ＜ 0.05);kyphotic Cobb angle descended from (21.2 ± 9.5) ° to (7.2 ±2.4) °in osteopenia group and from (23.1 ± 8.9) ° to (7.1 ± 2.6) ° in osteoporosis group (P ＜ 0.05).Three years after operation,all the parameters remained better than these before operation,with the value higher in osteoporosis group than in osteopenia group (P ＜ 0.05).Rate of refracture was higher in osteoporosis group after operation,compared to that in osteopenia group (P ＜ 0.05).Conclusions The clinical short-term result is satisfactory,but refracture rate is increased with the osteoporosis aggravation.Targeting osteoporosis therapy is important to obtain a better mid-term results.