Comparison Of Percutaneous Kyphoplasty And Percutaneous Pedicle Screw Fixation For The Treatment Of Vertebral Fractures At Specific Ages

Objective: To investigate the clinical outcomes of percutaneous kyphoplasty versus percutaneous pedicle screw fixation for osteoporotic vertebral compression fractures at specific ages.Methods: A retrospective comparative analysis was carried out by the Department of Orthopedics of Handan Central Hospital from January2019～December 2021,and 60 patients aged 55～65 years with mild and moderate osteoporotic vertebral compression fractures were treated.All 60 patients met the inclusion criteria,according to the surgical methods:percutaneous kyphoplasty was used in group A,percutaneous pedicle screw fixation was used in group B,and 30 cases were used in groups A and B.The duration of surgery and intraoperative blood loss between the two groups were compared through surgical records.After discharge,the length of hospital stay,postoperative complications and getting out of bed of the two groups were organized.The pain degree,Oswestry dysfunction index(ODI),activity of daily living score(ADL),Cobb angle,and vertebral compression ratio of the injured vertebral body were recorded and statistically analyzed at the preoperative and postoperative follow-up periods(1 day after surgery,1 month after surgery,3 months after surgery and 1 year after surgery).Through the above evaluation indicators,the short-term and long-term effects of the two groups under specific age groups were compared and analyzed.Results:(1)the duration of hospital stay,operation duration,intraoperative blood loss,and postoperative ambulation time were significantly lower in group A than in group B.(2)VAS score,ODI score and ADL score: there was no statistical difference between the two preoperative methods(P > 0.05).The VAS scores of group A were significantly lower(P< 0.05)than those of group B at each time period(1 day,1 month,and 3months after surgery).The ODI scores were significantly lower(P < 0.05)in group A than in group B at each time period(1 day,1 month,3 months,1year after surgery).ADL scores: the ADL scores of group B at each time point(1 day,1 month,3 months,and 1 year after surgery)were significantly lower than those of group A(1 day,1 month,3 months,and 1year after surgery),with statistical significance(P < 0.05).The VAS scores and ODI scores of group a versus group B decreased at 1 year after surgery.In contrast to groups A and B preoperatively,groups A and B significantly decreased(P < 0.05)at all time points postoperatively(1 day,1 month,3months,and 1 year postoperatively).The ADL scores of groups A and B increased at 1 year after surgery,and significantly(P < 0.05)higher ADL scores were observed at all time points(1 day,1 month,3 months and 1year after surgery)in groups A and B,and(4)Cobb angle,vertebral compression rate of injured vertebrae: there was no statistical difference between the two groups A and B before operation(P > 0.05).Group B was lower than group A at each time period with statistical significance(P < 0.05).A.In group B,the number of preoperative pairs significantly decreased compared with groups A and B at each postoperative time period(1 day after surgery,1 month after surgery,3 months after surgery and 1 year after surgery).(5)There were 2 cases of adjacent vertebral fracture,1 case of low back pain in group A and 1 case of liquefying of fat fluid in group B after surgery,while there was no statistical difference in complications between groups A and B(P > 0.05).Conclusions:Two minimally invasive procedures for mild to moderate OVCF under specific age groups achieved satisfactory outcomes in patients.Both minimally invasive procedures can relieve pain,repair damaged spine height,correct kyphosis,and improve patient quality of life by preoperative versus postoperative contrast.The two minimally invasive procedures have their own pros and cons,PKP has recently shown better pain relief,recovery of spinal function,and improvement of daily autonomy than ppsf,but some patients with PKP face risks such as adjacent vertebral body re fracture and loss of vertebral height postoperatively.Ppsf showed better recovery of injured vertebral height,establishment of a stable structure of the spine,prevention of loss of vertebral height,and promotion of fracture healing after surgery;However,the recent analgesic effect and functional recovery of ppsf were much less than those of PKP.For the middle-aged and elderly 55-65 years old,considering the need to return to normal physical labor in the long term after surgery,the choice of ppsf by treating OVCF at a specific age is more precise.