Percutaneous Balloon Dilatation Of Kyphoplasty And Conservative Therapy In The Treatment Of Osteoporotic Vertebral Compression Fractures

ObjectiveThrough the comparison of percutaneous balloon kyphoplasty (Percutaneous kyphoplasty, PKP) and conservative therapy in the treatment of osteoporotic vertebral compression fractures (Osteoporotic vertebral compression fractures, OVCF) the clinical curative effect, a detailed understanding of the advantages and disadvantages of two kinds of treatment, a clear grasp of osteoporotic vertebral compression fractures of the subjective the combination of indicators and objective indicators, to evaluate the effect of conservative treatment and PKP treatment. Through this research, to provide patients with a more theoretical basis for the treatment of osteoporotic vertebral fractures is safe and effective compression. Materials and methods1.1 general informationIn 2014 February 2015 February in Affiliated Hospital of Chengdu University of Traditional Chinese Medicine from osteoporotic vertebral compression fracture patients hospitalized in the Department of orthopedics,100 cases of clinical data were retrospectively analyzed.53 cases of percutaneous balloon kyphoplasty group, male 25 cases, female 27 cases, age 45-85 years old, average age is 65.4 years old, conservative treatment group 47 cases, male 23 cases, female 24 cases, age 46-88 years old, average age is 67.3 years old. The damage segment:T1125 cases, T1217 cases, L120 cases, L230 cases, L38 cases. Patients had no history of trauma, lumbar back pain, severe pain, activity was limited, improve bone mineral density measurement, X-ray, MRI examination after admission, admission diagnosis of fresh vertebral compression fracture. Two groups of patients in age, gender, symptoms, signs, imaging by statistical treatment the differences were not statistically significant (P> 0.05), comparable.1.2 treatmentThe rest of the conventional hard bed conservative treatment after admission, to diclofenac sodium dual release enteric coated capsules (Dai Fen) 75mg,1/d or 25mg oral oxymoron, particle/d; salmon calcitonin 50IU, intramuscular injection,1/d or be Canasta 5mg intravenous drip once a year, at the same time be acetic acid calcium and vitamin D 1600mg/d 400IU 1/d orally; at the same time be EA 1/d, the traditional Chinese medicine 1 times/d, waist and back muscle function exercise. PKP treatment group improve blood routine examination, biochemical, blood coagulation, blood transfusion before the full set, ECG, X-ray examination before operation, the prone position, high chest pad and bilateral iliac, blood pressure and oxygen saturation before operation, electrocardiogram, using Kitschier wire placed on the waist and back, in the C arm fluoroscopy location damaged vertebral pedicle, marking, the conventional disinfection shop towels, after anesthesia with needle and spinouts process was 2-3cm, pedicle 9 point position, tip to the midline of puncture, keep the camber of 10 DEG-15 DEG C arm fluoroscopy into position, with special syringe loaded bone cement 3-5ml, slow injection. X-ray detection of bone cement filling, pulling out the needles, local pressure dressing of gauze, postoperative bed rest,24 wear waist ambulation. Postoperative Canasta intravenous infusion of 5mg (once a year), continue to calcium acetate oral agent 600mg 1/d and 1/d of vitamin D 400iu.1.3 curative effect observationPatients were observed before and after treatment,24h,7 days after treatment,3 months after treatment,6 months after treatment, visual analogue scale (visual analogue scale, VAS method), oswestry disability index and Barthel index.ResultsAll of the patients after treatment, the pain was significantly relieved or disappeared, PKP group after treatment 24h pain was relieved after conservative treatment in treatment group 24h, no obvious pain relief, eased in March after 7 days, the pain disappeared or relieved obviously. Group PKP Oswestry functional index before and after the treatment in the first day there exist significant differences, the conservative treatment group Oswestry function index before treatment and third months after treatment there was a significant difference between PKP group and the conservative treatment, sixth months in the group Oswestry function index contrast there was no significant difference between PKP group and the conservative treatment, the treatment group comparison no significant difference in the Barthel index on.ConclusionPercutaneous balloon kyphoplasty (PKP) is a safe treatment method, can quickly relieve pain, compared with conservative treatment, shortening the time of bed rest, reducing the risk of deep vein thrombosis, pulmonary infection, gastrointestinal reaction and other complication caused by long-term bed. But the statistics in 3,6 months in the relief of pain, Oswestry disability index and Barthel index showed no significant difference, so the two kinds of treatment were no significant difference in the curative effect. Clinical studies show that, although PKP can effectively relieve pain, restore vertebral body height, enhance the advantages of stable operation of vertebral body, and the safety is high, but the price is more expensive. Compared with conservative treatment, can relieve pain and restore the vertebral body height in a short time, but the long-term effect is not obvious to see the difference. So for the treatment of patients with OVCF, because according to the patient’s condition, the general condition of patients and their own economic situation, to select suitable for treatment of patients with me.