Comparative Study Of Percutaneous Kyphoplasty And Conservative Therapy In Treating Osteoporotic Vertebral Compressive Fractures

Objective To compare the effects of percutaneous kyphoplasty (PKP) and conservative therapy for osteoporotic vertebral compression fractures.Methods A total of 96 patients with osteoporotic vertebral compression fractures were treated in October 2007 to January 2009 including 19 males and 46 females. They were randomly divided into two groups:group A,35 cases treated by percutaneous kyphoplasty; group B,30 were treated by conservative therapy. To compare and analyse before treatment, after treatment visual analog scales (VAS), Japanese Orthopaedic Association (JOA) scores, vertebral Cobb's angle and loss rate of vertebral body's height L% and the two groups of hospitalization time and complication rate.Results Two groups of 65 patients were treated, and were followed up for 6 to 30 months, an average of 12 months. group A have significantly eased the pain 3 days after PKP, VAS average scores decreased from 8.4 preoperatively to 2.4 (average decrease 6.0). B group of 30 patients had no significant change in VAS 3 days after conservative treatment. Group A VAS were significantly lower than group B at 3 days,1 month and 3 months after treatment, (P<0.05), both groups have no significant difference at 6 months after treatment (P>0.05). JOA score change consistent with changes of VAS.Postoperative Cobb's angle and L value of group A is less than pretreatment (P <0.05). Postoperative Cobb's angle and L value of group B is not improved compared with pretreatment (P<0.05) at 3 days after treatment. treatment began to improve at 1 month after treatment (P<0.05).L value and Cobb's angle of group A are more than group B after treatment (P<0.05). Vertebral height restoration and correction of deformity of group A is better than group B. hospitalization time in group A and group B is 3.2±1.1 days and 55.2±14.4 days, hospitalization time in group A was significantly shorter than group B (P<0.05). Complication rate 8.6% in group A was less than complication rate 40.0% in group B (P<0.05).Conclusion Conservative treatment of osteoporotic vertebral compression fractures has longer hospitalization time and higher rate of complication. and its pain relief and functional recovery time is long. percutaneous kyphoplasty is a simple, minimally invasive, safe and effective method, which can relieve pain rapidly and effectively restore vertebral height and correct deformities; and it is a ideal procedure for osteoporotic vertebral compression fractures.