Early Results Of Thoracolumbar Compression Fractures: A Clinical Trial Comparing Kyphoplasty With Conservative Therapy

ObjectiveTo assess the early results and safety of kyphoplasty and conservative therapy for thetreatment of thoracolumbar compression fractures with the pain score of numeric ratingscale, loss rate of vertebral height, and change of Cobb's angel.MethodA non-randomised clinical study was based on the concept of baseline date. Thepatients admitted as inpatients to JiangSu Province Hospital of TCM and Nanjing NO.1Hospital from May 2006 to January 2007 with acute thoracolumbar compression fractureswere enrolled. All of them were confirmed by symptoms and imaging examinations. Therewere no neurological deficits. They choosed the treatments voluntarily. It comprised 15patients treated by kyphoplasty and 15 by conservative therapy.Primary index—pain score of numeric rating scale was recorded at 24 hours beforethe baseline date and 24 hours, 1 week, 2～8 weeks and 12 weeks after the date. Secondaryindex—preoperative and postoperative loss rate of vertebra height and Cobb's angel wererecorded too.ResultsThere was no statistical significance(P=0.224) in the pain score of NRS since 4 weeksafter the baseline date. But the pain score in kyphoplasty-treated group sharply decreased from 5.77±2.62 preoperatively to 2.60±1.95 postoperatively(P＜0.01). The loss rate ofanterior and medium vertebral height were 27.39±13.71%,30.42±13.97% preoperativelyand 11.28±7.76%,12.48±7.49% postoperatively(P＜0.01). The Cobb's angle was improvedfrom 16.83±12.14°to 12.28±11.95°(P＜0.01).ConclusionKyphoplasty not only can provide early pain relief and effective vertebral heightrestoration, but also improve the function rapidly.However, pillow-pad therapy withfunctional exercise, careful attendence, and active prevention for complications can alsolead to a good result.