The Therapeutic Effect Of PVP Treating OVCF And Analysis Of Factors Influencing The Improvement Rate Of Vertebral Compression

Objective:To observe the postoperative clinical efficacy of Percutaneous vertebroplasty (PVP) for the treatment of osteoporotic vertebral compression fractures (OVCF), and to explore the factors which impact the improvement rate of vertebral compression. Method:55 patients with OVCF from Orthopaedics of Affiliated Hospital of Shandong University of Traditional Chinese Medicine in the past year (from 2008.9 to2009.10),who have had the PVP and a complete clinical follow-up data, were retrospectively analyzed. To analyze the preoperative and postoperative Cobb's angle and the compression ratio using the statistical method of t test, according to the clinical efficacy assessment (VAS pain score), clinical data (gender, age, weight, duration, cause fractures, fractures of vertebral body parts, surgery bone cement implantation dose) and imaging assessment (the extent of osteoporosis, preoperative and postoperative X-ray sagittal vertebral compression rate and the Cobb angle, with or without scoliosis, the degree of bone cement dispersion) before the surgery,1 week after surgery and 3 months after surgery, aiming at evaluating the effectiveness of surgeries. To do the univariate analysis with the statistical method of Linear correlation and Rank correlation, while using multiple linear regression analysis to do the multi-factor analysis, so as to study the relationship between various factors and the improvement of vertebral compression rate of PVP. Result: Significant difference (p<0.05)was found on VAS pain score, vertebral compression rate and the comparison of Cobb's angle 1 week after the surgery than before, while the results between 1 week after the surgery and three months after the surgery had no significant difference (P>0.05).The single factor analysis showed correlations between that the postoperative improvement of vertebral compression rate and preoperative vertebral compression rate, the degree of osteoporosis, bone cement dispersion degree and the course (P<0.05), while no correlation (P>0.05) with patients' sex, age, weight, fracture cause, with or without scoliosis, preoperative sagittal Cobb angle, bone cement implantation dose and location of the fracture. Multivariate analysis showed that preoperative vertebral osteoporosis, the degree of vertebral compression rate and duration were the major factors which affected the improvement of vertebral compression rate (P<0.01),with the standardized partial regression coefficients of 0.165,0.519 and -0.380. Conclusion:Treatment of OVCF by PVP has a good postoperative curative effect. Osteoporotic vertebral body level before surgery, preoperative vertebral compression rate, duration and bone cement dispersion degree have significant effect on the restoration of vertebral compression rate, and the first three indicators are independent factors. Preoperative evaluation of these indicators will play a positive role in improving the prognosis of vertebral compression rate after PVP.