| Objective: By on elderly patients with thoracolumbar compression fractures operative and non operative treatment of three years of review of pre survey, optimize and standardize the for aged thoracic lumbar vertebral compression fracture characteristics of the treatment and the prospective comparative studies have attempted to establish conforms to the new clinical treatment options.Methods: Kunming Hospital of traditional Chinese Medicine Department of Orthopaedics and traumatology in 2012 to 2014 to carry out the elderly thoracolumbar compression fracture after percutaneous balloon dilatation of vertebral kyphoplasty(PKP)surgery and non surgery therapy for pre survey, optimize and standardize the for elderly patients with thoracolumbar compression fracture characteristics of the treatment. For;for prospective comparative study: according to the pre investigation and optimization to improve the existing treatment options, the elderly thoracic and lumbar vertebral compression fractures were set as experimental study section, in this section, according to patients with vertebral height loss rate to vertebral height loss to 1 / 3 of the boundary point, < 1 / 3, it is standard to take the non operative therapy, the treatment group B and control group B for the pre survey < 1 / 3 underwent percutaneous balloon vertebral kyphosis plasty(PKP) is more than or equal to 1 / 3, it is standardized by percutaneous balloon dilatation of vertebral kyphosis plasty(PKP) treatment, the treatment group and the control group a pre investigation is more than or equal to 1 / 3 and non operative therapy. Then hospital from 2015 in January 1, 2015 December 31 in Kunming Hospital of traditional Chinese Medicine Department of Orthopaedics and traumatology and in accordance with the inclusion criteria of senile thoracolumbar compression fractures hospitalized patients according to the random number table method, treatment group A and group B group randomly selected 20 specification treatment. Record the clinical observation indicators, and finally use statistical methods to determine the resultsResults:Presurvey:1.Through the pre survey, prospective comparative research of the aged thoracic vertebral compression fractures were set as the experimental study of segment, in this section, according to the patients with vertebral height loss rate, vertebral height loss is up to one-third is bounded. < 1 / 3 is taken non operative therapy; is more than or equal to1 / 3 is taken by percutaneous balloon dilatation of vertebral kyphoplasty(PKP) treatment as treatment of choice.2.Presurvey after percutaneous balloon dilatation of the vertebral body(PKP) patients get out of bed mean 2.3 days, not more than 3 days, the length of stay is 9.1 days,followed by more than March, June, a year or even longer. In combination with the actual situation of this study, the prospective comparative study was made to observe and record the time of 3 days, 10 days, 3 days after treatment.3.Preinvestigation of percutaneous balloon dilatation of the vertebral body(PKP) after the unilateral approach to Louis' s recovery is not ideal, the reason may be that the unilateral approach of bone cement in the vertebral body uneven distribution. Unilateral approach to increase the risk of surgery, the reason may be that sometimes for the pursuit of bone cement filling degree, the pressure is difficult to grasp, easy to cause bone cement leakage. Therefore, prospective comparative study of percutaneous balloon dilatation of the percutaneous balloon dilatation of the vertebral body(PKP) in patients with bilateral approach.4.The presurvey found that percutaneous balloon dilatation of the vertebral body(PKP)in the treatment of senile thoracolumbar vertebral compression fracture of fresh fractures than the old fracture. A prospective comparative study will only make a study of the efficacy of fresh fractures.5.Non operative treatment of hyperextension reduction, waist pillow, acupuncture and cupping and physiotherapy, exercise and drug treatment. The pre survey found that patients did not regulate the systematic treatment of non surgical treatment for various reasons. Prospective comparative study will strictly implement a set of non surgical treatment system.Prospective comparative study:1. treatment of A group and control group A statistical comparison:1.1The comparison results of the two groups after 3 days of treatment:There was a very significant difference between the two groups in the pain score(version visual pain score)(P < 0.01). The treatment group was better than the control group A in the A group. The JOA scores of the two groups were significantly different(P< 0.01), and the treatment group A was better than the control group A. Comparison of the two groups of Cobbs score was very significant difference(P < 0.01), the treatment of A group was better than the control group A. There was very significant difference between the two groups(P< 0.01). The treatment group was better than that in the control group A group A.1.2The 10 days after treatment in two groups of results:There was a very significant difference between the two groups in the pain score(version visual pain score)(P < 0.01). The treatment group was better than the control group A in the A group. The JOA scores of the two groups were significantly different(P< 0.01), and the treatment group A was better than the control group A. Comparison of the two groups of Cobbs score was very significant difference(P< 0.01), the treatment of A group was better than the control group A. There was very significant difference between the two groups(P < 0.01). The treatment group was better than that in the control group A group A.1.3The comparison results of the two groups after 3 months:There was a significant difference between the two groups in pain score(version visual pain score)(P< 0.05). There was significant difference between the two groups in JOA scores(P < 0.05). Comparison of the two groups of Cobbs score was very significant difference(P < 0.01), the treatment of A group was better than the control group A. There was very significant difference between the two groups(P < 0.01). The treatment group was better than that in the control group A group A.1.4The cure rate of the treatment group A was significantly better than that of the control group A, there was a very significant difference(P < 0.01). The treatment of A group out of bed time, functional exercise time was significantly better than the control group A, there is a very significant difference(P < 0.01). Compared with the control group, the incidence of complications in group A and group A was significantly different(P < 0.01), and the control group A was higher than that in the control group A.2, treatment of B group and control group B statistical comparison.2.1The comparison results of the two groups after 3 days of treatment:There was a very significant difference between the two groups in pain scores(version visual pain score)(P < 0.01), and the control group B was better than that in the treatment group B. There was very significant difference in JOA scores between the two groups(P < 0.01), and the control group B was better than that in the treatment group B.There was significant difference between the two groups in the Cobbs score(P < 0.05),and the control group B was better than that in the treatment group B. There was significant difference between the two groups(P < 0.05), and the control group B was better than that in the treatment group B2.2The 10 days after treatment in two groups of results:There was a very significant difference between the two groups in pain scores(version visual pain score)(P < 0.01), and the control group B was better than that in the treatment group B. There were significant differences in JOA scores between the two groups(P < 0.05), and the control group B was better than that of the B group. There was significant difference between the two groups in the Cobbs score(P < 0.05), and the control group B was better than that in the treatment group B. There was significant difference between the two groups(P < 0.05), and the control group B was better than that in the treatment group B2.3The comparison results of the two groups after 3 months:There was no significant difference between the two groups(version visual pain score)(P > 0.05). There was no significant difference in JOA scores between the two groups(P > 0.05). There was significant difference between the two groups in the Cobbs score(P < 0.05), and the control group B was better than that in the treatment group B.There was no significant difference between the two groups(P > 0.05)2.4There was no significant difference in cure rate between group B and group B(P > 0.05). Compared with the treatment group B, the bed time, functional exercise time was significantly better than the treatment group B, there were very significant differences(P < 0.01). There was no significant difference in the incidence of complications between group B and group B(P > 0.05)Conclusion:In the treatment of elderly patients with thoracolumbar compression fracture of vertebral height loss rate is more than or equal to 1 / 3, the percutaneous balloon dilatation of vertebral kyphoplasty(PKP) whether early or long-term has better clinical effect is of choice in treatment of the senile thoracolumbar compression fracture.And in the treatment of senile thoracolumbar compression compression fractures of vertebral height loss rate < 1 / 3 when, after percutaneous balloon dilatation of vertebral kyphoplasty(PKP) in early pain relief and early get out of bed with good clinical effect.Although on the medium and long term, after percutaneous balloon dilatation of vertebral kyphoplasty(PKP) surgery and non surgery therapy has a good clinical efficacy,individuals based on the actual situation, select the appropriate treatment options.It is reasonable and scientific to optimize and improve the treatment choice after the pre investigation. It can be used to guide clinical work as a new treatment plan. |
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