| 【Purpose】To compare the efficacy and safety of PVP and PKP in the treatment of single segmental OVCF.【Methods】To review the OVCF patients admitted to our hospital from January 2017 to December 2019.According to the uniform inclusion and exclusion criteria,65 cases were selected,of which 32 cases of PVP,33 were treated with PKP.The clinical and image data of the two groups were collected,and the efficacy and safety were compared by several indicators.These indicators are: 1 VAS score before operation,the first day after operation,1 month after operation;2 changes in the height of responsible vertebrae before and after operation;3 kyphosis correction of responsible vertebrae before and after operation;4 bone cement leakage.【Results】1 Comparison of general data between the two groups: in PVP group,there were 9 males and 23 females,with an average age of 73.91±10.52.The days of hospitalization was 6.81±3.12.There were 21 cases of w-shape and 11 cases of v-shape.In PKP group,there were 9 males and 24 females,with an average age of72.58±10.05.The days of hospitalization was 6.18±3.05.There were 25 cases of w-shape and 8 cases of v-shape.There was no significant difference in gender,age,days of hospitalization and fracture classification between the two groups(P>0.05).There was comparability between the two groups.2 In PVP group: there was significant difference in VAS score between pre-operation and first day after operation(LSD-t=25.013,P<0.001).There was significant difference in VAS score between pre-operation and 1 month after operation(LSD-t=26.847,P<0.001).There was no significant difference in VAS score between 1 day and 1 month after operation(LSD-t=1.835,P=0.069).In PKP group: there was significant difference in VAS score between pre-operation and first day after operation(LSD-t=26.847,P<0.001).There was significant difference in VAS score between pre-operation and 1 month after operation(LSD-t=28.754,P<0.001).There was no significant difference in VAS score between 1 day and 1month after operation(LSD-t=1.907,P=0.059).Both groups could effectively relieve low back pain,and the degree of pain at first day after operation was the same as that at 1 month after operation.There was no significant difference in VAS score between the two groups before operation,1 day after operation and 1 month after operation,suggesting that the two methods were equally effective in relieving pain.3 The difference of vertebral compression before operation(35.53±17.17)%and after operation(27.08±17.28)% in the PVP group was statistically significant(t=8.184,P<0.001),and the difference of vertebral compression before operation(40.26±19.01)% and after operation(17.65±11.63)% in the PKP group was statistically significant(t=9.027,P<0.001).There was no significant difference in vertebral compression before operation between the two groups(t=-1.051,P=0.297>0.05).The vertebral compression rate after operation of the PKP group was much more lower than that of the PVP group,and the difference was statistically significant(t=2.588,P=0.012<0.05).The compression correction rate of the PKP group(22.60±14.38)% was higher than that of the PVP group(8.45±5.84)%,and the difference was statistically significant(t=-5.23,P<0.001),indicating that PKP could reduce the compression rate of the vertebral body and restore the height of the responsible vertebral body to a greater extent.4 The difference of KA before operation(17.47±11.03)° and after operation(14.80±10.57)° in PVP group was statistically significant(t=6.083,P<0.001).In PKP group,the median of KA,before and after operation was 16.70(11.8)° and8.90(12.25)° respectively,and there was significant difference between pre-operation and post-operation(Z=-5.012,P<0.001).Both PVP and PKP can effectively correct the kyphosis Cobb Angle of vertebral body.The median of PVP group was 2.00(3.15)°,and the median of PKP group was 4.30(5.55)°.There was significant difference in the degree of kyphosis correction between the two groups(Z=6.831,P=0.018<0.05).It is suggested that PKP can correct kyphosis to a greater extent than PVP.5 Leakage occurred in 18 cases in the PVP group,and the leakage rate was56.25%.Leakage occurred in 8 cases in the PKP group,with a leakage rate of24.24%.The rate of cement leakage in the PKP group was significantly lower than that in the PVP group(χ2=6.935,P=0.008<0.05),and PKP could reduce PMMA cement leakage.【Conclusion】For patients with single segmental osteoporotic vertebral compression fracture,pain symptoms can be relieved immediately,and vertebral height can be restored and kyphosis angle can be corrected whether treated with PVP or PKP.Compared with PVP,PKP can correct kyphosis angle to a greater extent,restore the compressed height of responsible vertebrae and reduce cement leakage. |
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