Therapeutic observations on 28 cases of adjacent vertebral fractures after PKP

QIU Zhi-xue; SHAN Zhong-shu

doi:10.3969/j.issn.1009-4237.2017.03.011

Abstract：Objective To discuss the clinical efficacy of percutaneous kyphoplasty(PKP) and percutaneous vertebroplasty(PVP) on adjacent vertebral fractures in osteoporotic vertebral compression fracture (OVCF) patients after PKP.Methods Twenty-eight patients of adjacent vertebral fractures after PKP admitted from Jan.2012 to Feb.2015 in our hospital were selected.Sixteen patients [4 males and 12 females aged from 58 to 89 (average,69.8) years] accepting PVP for the treatment were taken as Group A;while other 12 cases [3 males and 9 females aged from 56 to 88 (average,67.6) years] accepting PKP for the treatment were classified into Group B.Statistical analyses were completed for Visual Analogue Scale(VAS) scores and the number of subsequent adjacent vertebral fractures of patients in both groups before and 2 days after PKP and PVP as well as during follow-up visits.Results The VAS scores of pre-operation,2 days after surgery and final follow-up visit for Group A were (7.9±1.6),(2.0±0.9) and (2.9±1.1),respectively;while the VAS scores of pre-operation,2 days after surgery and the final follow-up visit for Group B were (7.8±1.7),(2.0±0.7) and (2.2±0.8),respectively.The VAS scores of 2 days after surgery and the final follow-up visit for both groups were significantly lower than those of pre-operation(P<0.01).The VAS score of the final follow-up visit in Group A was higher than that of 2 days after surgery(P<0.05),while there was no significant difference between the VAS scores of follow-up visits and 2 days after surgery in group B(P>0.05).The VAS score of Group A was higher than that of Group B during the final follow-up visit(P<0.05),and no statistical difference was found in VAS scores of pre-operation and 2 days after surgery between the two groups.During the final follow-up visit,four cases in Group A were suffering from adjacent vertebral fractures for a second or third time;however,there was only one case in Group B who was confronting the same situation;and the adjacent vertebral fractures in both groups occurred within 3 spines adjacent to the initial vertebral fracture.Conclusion The 3 spines adjacent to the initial fracture were the predilection sites of vertebral fractures after PKP.Both PVP and PKP were effective methods for the treatment of adjacent vertebral fractures after PKP.However,the probability of a subsequent fracture after the treatment of PKP is lower than that of PVP.