Comparative Study On The Effect Of Percutaneous Vertebroplasty And Percutaneous Kyphoplasty For Osteoporosis Vertebral Compression Fracture Patients With Spinal Canal Compromise

Objective: Compared the efficacy of percutaneous vertebroplasty(PVP) with percutaneous kyphoplasty(PKP) in the treatment of spinal canal compromise without neurological symptoms Osteoporosis Vertebral Compression Fractures(OVCF) patients.Methods: We reviewed OVCF patients who were treated in the Department of Orthopedics of the 175 th Hospital of PLA from January 2013 to January 2016. The group PVP included 45 patients, and the group PKP included 48 patients. Compared the operation time, fluoroscopy time, hospital stays, hospitalization expenses, recovery rates of wedged vertebral body height(of the first, middle, and last thirds), correction rates of wedge angles, incidence of cement leakage, and incidence of adjacent vertebral fracture of two groups patients. Visual analogue scale(VAS) and Oswestry disability index(ODI) were adopted to assess pain degree and disability condition. The VAS and ODI of two groups were compared at different postoperative follow-up intervals.Results: After operation, the mean follow-up period of 93 patients was 10.5 months(9-17 months). The operation time, fluoroscopy time, hospital stays, hospitalization expenses, recovery rates of wedged vertebral body height(of the first, middle, and last thirds), correction rates of wedge angles, incidence of cement leakage, and incidence of adjacent vertebral fracture of two groups patients were(25.50±8.64) min and(36.78±7.27)min,(3.91±1.17) min and(11.10±1.53) min,(5.27±1.12) d and(5.27±0.94)d,(25905.06±4394.11) RMB and(36334.20±3061.33) RMB,(5.59%±8.35% and35.16%±26.74%, 2.51%±3.21% and 35.14%±25.80%, 0.52%±0.37% and41.51%±30.88%), 2.08%±3.00% and 20.31%±14.25%, 31.11% and 12.50%, 26.67% and 16.67%, respectively. The operation time, fluoroscopy time, hospital stays,hospitalization expenses, correction rates of wedge angles, recovery rates of wedged vertebral body height, and incidence of cement leakage of two groups were compared respectively, the differences between two groups were statistically significant(p<0.05).The differences between two groups were not statistically significant(p>0.05) after compared the hospital stays of two groups. The incidence of adjacent vertebral fracture of two groups were not statistically significant(p>0.05). Compared the ODI and VAS of two groups respectively on the day before the operation, the first day after the operation, the sixth month after the operation, and the latest follow-up, there were no significant differences(p>0.05).Conclusion: For spinal canal compromise without neurological symptoms OVCF patients, both PVP and PKP can achieve the same efficacy in relieving pain and changing ODI. PVP is superior to PKP in hospitalization expenses and fluoroscopy time.And PKP is superior to PVP in restoring wedged vertebral body height, correcting wedge angles, and decreasing the rate of bone cement leakage. For such OVCF patients,the surgical option should be combined with the degree of vertebral compression, the degree of spinal canal compromise, and patients’ economic capacity.