A Comparison Analysis Between Percutaneous Vertebroplasty And Conservative Therapy In Osteoporotic Vertebral Compressive Fractures

Objective:To study the treatment results between percutaneous vertebroplasty (PVP) and traditional conservative therapy in osteoporotic vertebral compressive fractures (OVCF),and to evaluate the clinical value of PVP. Methods:According to the criteria and principle,65 patients was selected in Affiliated Hospital of Shan dong University of Traditional Chinese Medicine from September 2008 to September 2009,And there are 21 cases with conservative treatment and 44 cases with PVP. All patients were noted by VAS (Visual analogue scales, VAS) rating scale,ODI (Oswestry disability index, ODI) scale, JOA with low back pain scale, and through a standard lateral X-ray measurement of Cobb angle changes before surgery and after operation in 1 days,l month,3 months,6 months respectively.The treatment results of OVCF with two methods were statistical analysed, complications and vertebral fractures were recorded randomly. Results:All patients were followed up, there was a significant difference between conservative group and PVP with VAS score from7.68±0.80 to 2.47±0.96, JOA score from 12.86±2.16 to 23.20±1.55, ODI score from 76.68±3.85 to 16.25±2.92 in 1 day, (P<0.01); and there was still a significant difference between the two groups in VAS,JOA and ODI score in 1 month and 3 months,otherwise two groups were kept basic line in 6 months. There was no changs in Cobb angle changes with PVP after 1,3,6 months (20.27±3.01); there was no significant difference between preoperative and treatment after 1 months in conservative therapy (P=0.091). Nevertheless, both of them have gradually been decreased.There was no remarkable changes in Cobb angle after 1,3,6 months' treatment,however,all of them have gradually been increased. There were 8 complications which were related to bone cement leakage in PVP, but the spinal cord and nerve compression symptoms have not occurred in all cases,the rate of bone cement leakage was 18%; bedsore in 1 case and urinary tract infection in 1 case have occurred inconservative group. There was adjacent vertebral fractures afer 2 months in PVP.Conclusion:PVP is an reliable treatment in OVCF,which can relieve pain quickly and effectively and make the vertebral body stable. At the same time,it can shorten the patient's bedtime and avoid the complications of long-term bed, which have the tiny surgical trauma and the less serious complications.Similarly, conservative treatment can ease pain symptoms and have the lower cost,but the long course,large suffering,the high incidence of complications are its shortcoming.