Comparison Of Clinical Efficacy Of Directional Balloon PKP And Common PKP In The Treatment Of Osteoporotic Vertebral Compression Fractures

Background & objective: Osteoporosis Vertebral Compression Fracture(OVCF)is one of the serious complications in the elderly patients with osteoporosis(OP).For the patients with OVCF,there are two main treatments: conservative treatment and minimally invasive surgery.Due to the limitations of the conservative treatment,it is not suitable for severe vertebral fracture and elderly frail patients.So minimally invasive surgical treatment is currently the main method to treat OVCF.At present,the main methods of minimally invasive surgery are Percutaneous Vertebro plasty(PVP)and Percutaneous kypho plasty(PKP).Because common PVP and PKP have some shortcomings in complications and safety,so in this study we developed the technique of directional balloon PKP on the basis of general PKP,and analyzed and evaluated the efficacy of directed balloon PKP in the treatment of OVCF by clinical retrospective study.Methods: This study selected 45 cases of osteoporotic vertebral compression fractures were treated with directional balloon PKP in our hospital from October 2016 to October 2017 as observation group,selected 75 cases of osteoporotic vertebral compression fractures were treated with common PKP from October 2009 to October 2017 as control group.The cases in both groups were treated with unilateral puncture.The age of male patients was 55-85 years(mean 68.5 years),and that of female patients was 50-85 years old(mean 71 years).The preoperative bone mineral density(BMD)was less than-2.5 SD.The bone cement injection was about 3~5 ml in thoracic vertebra and 4~8 ml in lumbar vertebra.The leakage rate of bone cement,the improvement of Cobb angle and wedge angle,the recovery of vertebral body height and the VSA score were compared between the two groups.Results: All the 120 cases in both groups were successfully operated without collateral injury and no balloon rupture.There were 10 cases with slight bone cement leakage(Leakage rate was 13.33%)in the common group and 1 case with slight bone cement leakage(Leakage rate 2.22%)in the directional group.The leakage rate of bone cement in the directional group was significantly lower than that in the common group(P < 0.05).The Cobb angle was 8.5 ±3.7°,wedge-shaped angle was 6.3 ±2.1°in the directional group postoperation,Cobb angle was 10.8 ±3.1°,wedge-shaped angle was 8.2 ±2.9°in the common group postoperation.Statistics showed that Cobb angle and wedge-shaped angle of the directional group was significantly superior to that of the common group(P < 0.05).The vertebral body height of postoperation in both groups was significantly higher than that preoperation(P < 0.05),the recovery value of vertebral height in directional group was significantly higher than that in common group(P < 0.05).There was no significant difference in the VAS score between the two groups(P > 0.05).Conclusion: The directional balloon PKP surgery can achieve good curative effect in the treatment of osteoporotic vertebral body compression fractures.It is better than the conventional balloon PKP surgery in reducing bone cement leakage rate,postoperative Cobb angle,wedge angle recovery and so on.