| Objective: To compare percutaneous kyphoplasty(PKP)combined with spinal nerve posterior branch radiofrequency(PRFT)and percutaneous kyphoplasty alone in the treatment of osteoporotic vertebral compression fractures(OVCF),and to explore the application and promotion value of PKP combined with PRFT in the treatment of OVCF.Methods: A retrospective analysis was performed on patients with single-segment osteoporotic compression fractures who were hospitalized in the Department of Spinal,the Third People’s Hospital of Dalian Medical University from September 2020 to December 2021.According to the inclusion and exclusion criteria,60 patients were selected and divided into PKP combined with PRFT group(PKP combined with PRFT group,PKP combined with PRFT group,PKP combined with PRFT group,PKP combined with PRFT group).30 cases)and PKP group(control group,30 cases).The general data of the two groups of patients were recorded,including gender,age,body mass index,duration of disease and vertebral fracture segment.The two groups of patients were followed up before operation and 12 months after operation.According to the follow-up results,the efficacy of all patients in the two groups at 12 months after operation was counted,and the modified Mac Nab criteria were used to evaluate the efficacy of each patient,and the excellent and good rate was calculated.The intraoperative bone cement dosage,the contrast of anterior vertebral height before and after treatment,and the improvement of Cobb Angle were recorded,and the improvement of spinal structure and function of the two groups were compared and evaluated.Visual analogue scale(VAS)and Oswestry disability index(ODI)were used to evaluate the pain improvement of the two groups before operation and at 1 day,1week,1 month,3 months,6 months and 12 months after operation.The surgical data of the two groups,new fractures and complications during the follow-up period were recorded to evaluate the safety of the two groups.Results: All patients completed preoperative diagnosis and postoperative follow-up,and there was no significant difference in general clinical data between the two groups.In terms of clinical efficacy indicators,the excellent and good rates of the combined group and the control group at 12 months after operation were 96.7% and 93.3%,respectively,with no significant difference between the two groups(P > 0.05).The amount of bone cement in the combined group and the control group was 5.87±1.23 ml and 5.90±1.25 ml,respectively,and there was no significant difference between the two groups(P > 0.05).The anterior vertebral body heights of the combined group and the control group were 19.23±2.01 mm and 18.93±1.12 mm before and after operation,and 27.47±2.85 mm and 26.97±1.74 mm after operation,respectively.The anterior vertebral body heights of the two groups were significantly improved after operation(P< 0.05).There was no significant difference in the anterior vertebral height between the two groups before and after operation(P > 0.05).The Cobb angles of the combined group and the control group were 27.23±3.01° and 26.37±3.05° before and after operation,and 16.60±2.79° and 16.77±2.89° after operation,respectively.The Cobb angles of the two groups were improved significantly(P < 0.05).There was no significant difference in Cobb Angle between the two groups before and after operation(P > 0.05).The VAS score and ODI index of the two groups at each observation time point during the follow-up period were significantly lower than those before operation(P < 0.05),and the improvement of the combined group at each observation time point was more obvious than that of the control group(P < 0.05).In terms of safety indicators,the operation time of the combined there was a significant difference between the group and the control group(P<0.05).No significant difference in surgery blood loss between the combined group and the control group(P > 0.05).There was no significant difference in the incidence of new vertebral fractures and complications between the combined group and the control group during the follow-up period.Conclusions: PKP combined with PRFT and PKP alone have definite curative effect on the treatment of OVCF,but PKP combined with PRFT is more conducive to reducing the pain of OVCF patients,improving the function of patients,and improving the quality of life of patients.It is a safe and effective method to achieve better pain control with a very short increase in operation time. |
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