[Analysis of clinical effects of percutaneous vertebroplasty and percutaneous kyphoplasty in treating osteoporotic vertebral compression fracture].

OBJECTIVE: To explore the clinical outcomes of percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) in treating osteoporotic vertebral compression fracture (OVCF). METHODS: From January 2007 to February 2010, the data of 40 patients with osteoporotic vertebral compression fracture underwent treatment were retrospectively analyzed. Of them,20 patients were treated with PVP (PVP group), there were 8 males and 12 females with an average age of (66.37 +/- 2.34) years old (54 to 81); 20 patients were treated with PKP (PKP group), there were 11 males and 9 females with an average of (65.12 +/- 3.21) years old (56 to 79). Postoperative at 1 week, 12 weeks, 1 year, pain and daily life function were respectively assessed by visual analogue scale (VAS) and Barthel index (BI); and anterior height of responsibility vertebra, Cobb angle were measured by X-rays. RESULTS: In PVP group, 1 case complicated with bone cement leakage without clinical symptoms and no operation to treat. No postoperative infection and deep vein thrombosis were found between two groups. All patients were followed up more than 1 year, pain and daily life function has obviously improved than preoperative (P < 0.01); and there was no significant difference on 1 week, 12 weeks, 1 year after operation (P > 0.05); there was no significant difference between two groups (P > 0.05). In PVP group, there was no significant difference in anterior height of responsibility vertebra, Cobb angle before and after operation;and in PKP group, postoperative data has obviously improved than preoperative (P < 0.01), but there was no significant difference postoperative at 1 week, 12 weeks, 1 year (P > 0.05); there was no significant difference between two groups at 1 week, 12 weeks, 1 year after operation. CONCLUSION: Both the methods can obviously relieve pain and completely or partly recover daily life function in treating OVCF. But PKP has advantages of recovery of anterior height of responsibility vertebra and correction of Cobb angle, especially for serious compression.

[Comparison of lung volume response with airflow response to bronchodilator in patients with chronic obstructive pulmonary disease].

OBJECTIVE: the reversibility of chronic obstructive pulmonary disease (COPD) is evaluated mainly by FEV(1) after bronchodilators. However, lung volumes also change significantly in COPD, but few studies addressed the characteristics of the changes in post bronchodilator airflow and lung volume in patients with COPD. This study was carried out to evaluate the difference of FEV(1) response and forced vital capacity (FVC) response to bronchodilators in patients with COPD as well as the impact of severity of COPD on the flow and volume reversibility. METHODS: 465 patients with COPD (male 426, female 39), aged 67.1 +/- 8.3 (42 approximately 86) yrs were enrolled from Jan. 2006 to Aug. 2008. The severity of COPD was graded according to the GOLD criteria. The change and rate of change of FVC and FEV(1) 20 minutes after inhalation of salbutamol 400 microg via spacer were measured and compared. Positive response to the bronchodilator was determined as FEV(1) or FVC increased 12% as well as 200 ml or above. The impacts of severity on flow and volume response were also studied. RESULTS: post-bronchodilator FEV(1) increased 117 ml with a 13.2% improvement on average compared with baseline. Post-bronchodilator FVC increased 258 ml and improved by 14.0% on average. The rate of positive reversibility in FEV(1) and FVC was 18.7% (87/465) and 44.1% (205/465), respectively. The improvement of FEV(1) decreased as a function of the severity of COPD. In contrast, the improvement of FVC was increased in those with more severe disease. CONCLUSION: the improvement of lung volume is more significant and maybe more important than airflow response in patients with COPD, especially in those with severe disease. In addition to FEV(1), the reversibility of COPD should also be evaluated by FVC.