Application Of O-arm Navigation System In Percutaneous Vertebroplasty(Kyphoplasty)for Osteoporotic Vertebral Compression Fractures

Objectives:To analyze the clinical effect of percutaneous Vertebroplasty(Kyphoplasty)(PVP/PKP)with the aid of O-arm navigation system in the treatment of osteoporotic vertebral compression fractures(OVCF).Methods:This study was divided into two parts:the application of o-arm navigation system assisted percutaneous Vertebroplasty(kyphoplasty)(PVP/PKP)in the treatment of osteoporotic vertebral compression fracture(OVCF)in the upper and middle thoracic vertebra and the application of lower thoracic vertebra and lumbar vertebra.Part I:Clinical data were collected from 25 patients diagnosed with osteoporotic vertebral compression fracture of upper and middle thoracic vertebra at the people's hospital of Zhengzhou University(Henan Provincial People's Hospital)from April 2018 to June 2019 and treated with O-arm navigation system assisted percutaneous Vertebroplasty(kyphoplasty)(PVP/PKP).The operative time and complications were recorded,and the anterior edge height,Visual Analogue Scale(VAS),Oswestry Disability index(ODI)of the injured vertebrae were recorded beforeoperation,3 days after and at the last follow-up.Part ?:Collect in April 2018 to June 2019 in the people's hospital of Zhengzhou University(Henan Provincial People's Hospital)under the diagnosis of thoracic and lumbar vertebral osteoporotic vertebral compression fractures of the clinical data of 44 patients,23 cases accepted O-arm navigation navigation system assisted percutaneous kyphoplasty(PKP),21 cases received traditional C-arm assisted percutaneous kyphoplasty(PKP).The operative time,injection amount of bone cement,leakage of bone cement,intraoperative radiation and other complications of the two groups were analyzed and compared.The anterior edge height of the vertebral body?Oswestry dysfunction score(ODI)and Visual analog score(VAS)were recorded before surgery,3 days after surgery and at the last follow-up,and SPSS21.0 software was used for statistical analysis of the collected data.Results:All the included patients successfully completed the operation without serious complications,and the follow-up was complete.Part ?:The operation time of the patients in this group was 34.2?56.7min,with an average of 45.41±5.43min.The time of intraoperative puncture ranged from 2.7 to 8.1 minutes each vertebral body,with an average of 5.66±1.32 minutes each vertebral body.The amount of bone cement in a single vertebra was 2.0-3.3ml,with an average of 2.59±0.33ml.The VAS and ODI scores at the 3d and the last follow-up after surgery significantly decreased compared with that before surgery,and the vertebral height significantly increased(p<0.05),and there was no statistical difference between the vertebral height,VAS score and ODI at the last follow-up and the 3d after surgery(p>0.05).There were 2 cases of bone cement leakage after operation,without obvious clinical symptoms.Part II:the VAS and ODI scores of the two groups were significantly reduced and the height of the anterior vertebral edge was significantly increased compared with that of the two groups at the 3 days and the last follow-up(p<0.05).The efficacy of the two surgical methods showed a parallel effect(p>0.05).The operation time of the O-arm group was slightly longer than that of the C-arm group,but there was no statistical significance at p>0.05.The injection amount of bone cement was greater than that of the C-arm group(p<0.05),but the intraoperative radiation was greater than that of the traditional C-arm group(p<0.05).The rate of cement leakage in the O-arm group was lower than that in the C-arm group(p<0.05),1 case of bone cement leakage occurred in the O-arm group,7 cases in the traditional C-arm group presented bone cement leakage,5 cases presented anterior vertebral leakage,3 cases presented intervertebral disc leakage,all without neurological symptoms,and no other complications occurred in the two groups.Conclusion:The clinical effect of O-arm navigation system assisted percutaneous vertebroplasty(kyphoplasty)in the treatment of OVCF in the upper and middle thoracic vertebrae is satisfactory.It has the advantages of precise puncture,high safety and fewer complications,and has a good application prospect.In the application of OVCF in the lower thoracic and lumbar vertebrae,the curative effect was similar to that of the traditional c-arm group,and it had the advantage of fewer complications,but the radiation amount for patients was greater than that of the c-arm group.