Changes of Spinal function and analysis of related factors before and after vertebral height recovery in Osteoporotic Vertebral Compression Fractures treated with three reduction methods

Abstract

Abstract Objectives To investigate the clinical effect of percutaneous vertebroplasty (percutaneous vertebroplasty, PVP) and percutaneous kyphoplasty (percutaneous kyphoplasty, PKP), PVP) in the treatment of osteoporotic vertebral fracture (osteoporotic vertebral compression fractures, OVCF). Methods From March 2016 to June 2019, we treated the patients who were admitted to our hospital from March 2016 to June 2019. The clinical data of 150 OVCF patients were analyzed retrospectively, and it was divided into PKP group (group A), PVP group (group B) and PVP + traditional Chinese medicine hyperextraction reduction method group (group C) according to different operation methods, and 50 cases in each group. Preoperative, postoperative 1d,3-month,6-month,1-year pain-visual analogue scale (VAS) was used to assess the degree of pain relief of the back and back of the patient, and the range of motion of the thoracolumbar spine was assessed. The recovery of degree, the recovery of kyphosis Cobb angle, the refracture of injured vertebrae and adjacent vertebrae after operation, and the trend of long-term stability of spine were followed up. Results The operation was smooth and there were no complications such as incision infection and deep venous thrombosis. At 3 months and 6 months after operation, there was significant difference between PVP overextended reduction group (group C) and PKP group (group A), PVP group (group B). The recovery rate of Cobb angle in sagittal plane of injured vertebrae was compared before and after operation. 1 day, 3 months, 6 months, 1 year follow-up. There was no significant difference between group C and group A and group B (P < 0.05). There was no significant difference between group B and group C (P < 0.05). The improvement rate of VAS in the three groups was significantly lower than that before operation, the pain was relieved and the function of daily life was improved significantly. On the 1st day, 3 months, 6 months and 1 year after operation, the improvement rate of VAS in group C was significantly different from that in group A. there was no significant difference between group B and group B (P < 0.05). There was no significant difference between group B and group C (P > 0.05). There was no significant difference in the improvement rate of ODI between group C and group A. there was no significant difference in the improvement rate of ODI between group C and group A. there was no significant difference in the improvement rate of ODI between group C and group A at 1 day, 3 months and 1 year after operation. During the follow-up of 6 months after operation, there was significant difference between group C and group A and group B (P < 0.05). There was significant difference between group C and group A at 1 month and 3 months after operation, and there was significant difference between group B and group B at 1 month, 3 months after operation (P < 0.05), and there was significant difference between group B and group B at 1 month and 3 months after operation (P < 0.05), and the risk of fracture and adjacent vertebral fracture was significantly higher than that in group B (P < 0.05). Year-to-year comparison of three groups There was no significant difference (P > 0.05). There was a significant difference between group C and group A and B at 1 month, 3 months and 6 months after operation (P < 0.05). One year after operation, there was no significant difference among the three groups (P > 0.05). Conclusions The three methods of reduction and fixation (PKP,PVP and PVP) are effective in relieving pain, strengthening vertebral body, stabilizing injured vertebra, restoring vertebral body height and correcting kyphosis of thoracolumbar spine. However, in the course of long-term follow-up, simple PVP The residual low back pain or recurrence in patients with PKP, the loss of the height of injured vertebrae, the occurrence of fractures and even the complications of refracture of adjacent vertebrae after enhanced operation, resulting in the decrease of the balance and long-term stability of spinal muscle and bone system. And then increase the degeneration process of the thoracolumbar segment of the spine.