Effect of percutaneous vertebroplasty and percutaneous kyphoplasty on adjacent intervertebral disc degeneration and mechanism

Tian Li; Meng Chun-yang; Xu Xiao-meng

doi:10.3969/j.issn.2095-4344.2014.44.015

Abstract：BACKGROUND:Compared with conservative treatment, percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) can rapidly relieve the pain caused by the compression of osteoporotic vertebral body. However, the perfusion of bone cement can not only restore the rigidity of fractured vertebrae, but also theoretical y alter the stress distribution of fractured vertebrae and increase the stress load of adjacent vertebrae, thus causing adjacent intervertebral disc degeneration. <br> OBJECTIVE:To observe the effects of PVP and PKP on the adjacent intervertebral disc degeneration and explore the possible mechanism. <br> METHODS:A total of 85 patients with osteoporotic vertebral compression fracture were divided into three groups:conservative treatment group (n=23), PVP group (n=42) and PKP group (n=23). ODI scores, DHI, MRII, and peripheral interleukin-1β, interleukin-6, tumor necrosis factor-αlevels were col ected and analyzed at different time points. <br> RESULTS AND CONCLUSION:The results showed that, PVP group and PKP group relieved pain effectively, reduced the time in bed, and had a better treatment satisfaction, but there were no significant differences in the scores of ODI scores between PVP group and PKP group at 24 months after discharge (P>0.05). At 24 months after discharge, MRII in the PVP group and PKP group were lower than that in conservative treatment group and before treatment (P<0.05), while peripheral interleukin-1, interleukin-6, tumor necrosis factor-αlevels were higher (P<0.05), there were significant differences between PVP group and PKP group (P<0.05). The disc degeneration adjacent to the fractured vertebral body can be accelerated by PVP and PKP procedures, and the latter is more serious. Interleukin-1, interleukin-6, tumor necrosis factor-αlevels are closely related to the degree of intervertebral disc degeneration.