Efficacy Of Percutaneous Vertebroplasty And Conservative Treatment For The Treatment Of Painful Osteoporotic Vertebral Compression Fractures

Objective: To compare the clinical efficacy of percutaneous vertebroplasty and conservative therapy for the treatment of painful osteoporotic vertebral compression fractures.Methods:Retrospective analysis of 143 cases of clinical date of patients with painful osteoporotic vertebral compression fractures who accepted treatments from February,2013 to February,2014 in Quanzhou First Hospital affiliated to Fujian Medical University. The patients were divided into the PVP group(who accepted percutaneous vertebroplasty) and the conservative group(who accepted conservative therapy).The efficacy assessment was conducted at newly hospitalized,1-3days after operation,3 months、6 months and1 year after operation.Both visual analogue scale(VAS) and Oswestry Disability index(ODI) were used to assess the efficacy at every time point.The overall follow-up time was 1year,and the data were collected to be analyzed statistically.The results:1 A total of 143 cases met the inclusion criteria, total deaths and people lost to follow-up were 13 cases, so 120 cases completed the one year’s following visits totally. There were 75 cases in the conservative group and 55 cases in the PVP group. There is one case of intervertebral bone cement leakage in the PVP group without obvious clinical symptoms. 2 VAS score: The VAS score of conservative group at newly hospitalized,1-3days after operation,3 months、6 months and1 year after operation were respectively(7.51 ± 1.21),(6.24 ± 1.20),(3.53 ± 1.20),(2.79 ± 1.09),(2.28 ± 0.97).There were significant diffirences between the VAS score at newly hospitalized,1-3days after operation and 3 months、6 months、1 year after operation(P <0.05) in the conservative group. The VAS score of PVP group at newly hospitalized,1-3days after operation,3 months、6 months and1 year after operation were respectively(7.40 ± 1.03),(3.56 ± 0.96),(2.69 ± 1.14),(2.58 ± 0.94),(2.40 ± 1.10).There were significant diffirences between the VAS score at newly hospitalized and 1-3days、3 months、6 months、1 year after operation(P <0.05)in the PVP group. There was no significant difference of the VAS score at newly hospitalized,6 months、1 year after operation between the conservative group and PVP group(P> 0.05) while significant differences of the VAS score at 1-3days and 3 months after operation existed between the two groups.(P< 0.05). 3 ODI index: The ODI index of conservative group at newly hospitalized,1-3days after operation,3 months、6 months and1 year after operation were respectively(75.23 ± 6.80),(73.96 ± 6.39),(47.88 ± 5.77),(41.00 ± 6.43),(31.23 ±6.86).There were significant diffirences between the ODI index at newly hospitalized,1-3days after operation and 3 months、6 months、1 year after operation(P <0.05) in the conservative group. The ODI index of PVP group at newly hospitalized,1-3days after operation,3 months、6 months and1 year after operation were respectively(73.01 ± 7.34),((48.77 ± 5.99),(43.92 when ± 5.17),(39.60 ± 6.51),(32.32±7.67).There were significant diffirences between the ODI index at newly hospitalized and 1-3days、3 months、6 months、1 year after operation(P <0.05)in the PVP group.There was no significant difference of the ODI index at newly hospitalized,6 months、1 year after operation between the conservative group and PVP group(P> 0.05) while significant differences of the ODI index at 1-3days and 3 months after operation existed between the two groups.(P< 0.05). 4 The result indicates that: The VAS score and ODI index within 3 months after operation of the PVP group were significantly lower than the conservative group, the difference was statistically significant(P< 0.05).Conclusion: Both the PVP and conservative therapy can be effective for the OVCF. However, the PVP is easier to operate, has less trauma and shorter operative time.And it is earlier,faster, more effective to alleviate the patients’ pain, increase the vertebral bone strength and improve the stability of the vertebral body than the conservative therapy, so that it enables the patients recover their mobility early, improve their quality of life and reduce the incidence of complications and mortality.