Changes Of Pulmonary Function And Correlated Analysis For Older Women Suffered From Osteoporotic Vertebral Compression Fractures After Kyphoplasty

Objective: To investigate the changes of pulmonary function for older women associated with osteoporotic vertebral compression fractures in thoracolumbar segment. Meanwhile, a prospective cohort study was performed to explore the improvement of pulmonary function for the patients after percutaneous kyphoplasty. Then the possible related factors of the changes were analyzed by statistic means. Methods: Fifteen older women with osteoporotic vertebral compression fractures in thoracolumbar segment were hospitalized and operated by percutaneous kyphoplasty from October 2002 to January 2005. Another fifteen healthy volunteers were selected as control. Age, height, weight, arm span, bone mineral density and thoracic kyphotic angle were measured and VC, IC, RV, FRC, TLC, FVC and MVV were selected as the parameters of pulmonary function in both groups. SPSS11.5 statistic software was used to analysis the difference between the two groups. Local kyphotic angle, mobility, pain scores were also been measured in patients group. Three days and one month after the procedure, all parameters were re-measured, and a questionnaire was used to evaluate life quality for each patient. Then to analysis the changes of the pulmonary function and the associated factors for patients preoperative, three days and one month after kyphoplasty. Results: The thoracic kyphotic angle was increased in patient group. Among the pulmonary parameters, although RV and FRC were retained, VC, IC, TLC, FVC and MVV were significantly lower than control. Three days after kyphoplasty, the height of vertebral body was restored significantly, the average local kyphotic anglewas improved from 24.9° to 16.4° , the back pain was relieved dramatically from 8.3 to 3.0 (VAS),and the mobility was increased from 2.7 to 1.7 . Meanwhile, FVC and MVV were increased significantly, the previous from 2.24L to 2.34L, the latter from 57.55L to 58.58L. One month after the procedure, the restored vertebral height and angle have no significant change, while mobility was continual to increase from 1.7 to 1.2. Among all the parameters of pulmonary function, only MVV continues to improve from 58.58L to 60.65L. There is a significant negative correlation between thoracic kyphotic angle and VC and IC. The local kyphotic angle has no correlation with any of the pulmonary functional parameters. The value of the decrease of pain scores has remarkably positive correlated with the improvement of FVC and MVV measured three days after kyphoplasty. Conclusion: Restrictive impairment of pulmonary function was testified in patients with osteoporotic vertebral compression fractures in thoracolumbar segment. Three days after kyphoplasty, the pain was significantly relieved and sagittal alignment was improved, associated with the increase of FVC and MVV. The improvement of FVC and MVV has positive correlation with the decrease of VSA. One month later, activity amount was increased, the results of kyphoplasty were stable and MVV continued to improve.