Comparison Of PKP And PVP In 1/3 Of Acute Osteoporotic Vertebral Compression Fractures Involving The Vertebral Body

Objective:For acute osteoporotic vertebral compression fracture(OVCF),detailed analysis was conducted to the vertebral involvement site in this paper,aiming to explore 1/3of AOVCF patients with vertebral fracture involvement.The comparison of the efficacy of percutaneous kyphoplasty(PKP)and percutaneous vertebroplasty(PVP)in order to provide reference for the selection of clinical treatment methods.Methods:A total of 117 single-level AOVCF patients who met the inclusion criteria admitted to our hospital from January 2017 to December 2018 were retrospectively included,and classified according to surgical methods,including 61 cases in the PVP group and 56 cases in the PKP group.Clinical data of all patients were collected in detail.Patients in the two groups were measured in age,sex,height,weight,bone cement injection volume,preoperative bone mineral density(BMD),visual analogue score(VAS),ostry disability index(ODI),SF-36 score(SF-36),anterior vertebral height(AVH),and fracture vertebra cobb angle(FVCA)have no statistical differences and are comparable.AVH and FVCA at different time periods(preoperative,postoperative 1d,and last follow-up)were measured on sagittal radiograph,and the incidence of bone cement leakage(BML)and adjacent vertebral fractures(AVF)in both groups were recorded.The t test and chi-square test was used to compare the observation indexes between the two groups and evaluate the surgical efficacy.Results:There were no significant differences in age,sex,height,weight,preoperative BMD and bone cement injection volume between the two groups(P > 0.05).VAS score,ODI score and SF-36 score of PVP group and PKP group at postoperative 1 day and last follow-up were all better than those before surgery,and the last follow-up was better than those on postoperative 1 day(P < 0.05).There was no significant difference in scores between two groups(P > 0.05).AVH and FVCA in PVP and PKP groups were better than those before operation at 1 day after operation and the last follow-up,the difference was statistically significant(P < 0.05),there was no significant difference between the last follow-up and the first day after surgery(P > 0.05),the AVH of the PKP group were higher and the FVCA were lower than that of the PVP group at 1 day after surgery and the last follow-up,and the differences were statistically significant(P < 0.05).BCL was found in 18patients(29.5%)of PVP group and 7 patients(12.5%)of PKP group,and the difference between the two groups was statistically significant(P < 0.05).There were 11 cases(18.0%)of AVF in PVP group and 3 cases(5.4%)in PKP group,and the difference between the two groups was statistically significant(P < 0.05).The operative time,intraoperative blood loss and hospitalization cost of PVP group were lower than those of PKP group,and the difference was statistically significant(P < 0.05).Conclusion:Both PVP and PKP have good analgesic effects.Although PKP is slightly higher in the amount of blood loss,operation time and cost,PKP has a better performance in the recovery of AVH and FVCA,and the incidence of BCL and AVF are low.Therefore,after comprehensive consideration,PKP surgery is recommended for the treatment of 1/3 of AOVCF with fracture involvement in the vertebral body.