Percutaneous vertebroplasty, percutaneous kyphoplasty and expansive pedicle screw fixation for repairing primary osteoporotic thoracolumbar fractures

Wang Ling; Zhao Hong-xia; Hua Qiang

doi:10.3969/j.issn.2095-4344.2017.03.005

Abstract：BACKGROUND:Percutaneous vertebroplasty, percutaneous kyphoplasty and expandable pedicle screw fixation can treat primary osteoporotic thoracolumbar fractures. The three methods have their own advantages and disadvantages. OBJECTIVE:To investigate the methods and clinical effects of primary osteoporotic thoracolumbar fractures. METHODS:Clinical data of 61 patients with primary osteoporotic thoracolumbar fractures were col ected and retrospectively analyzed. Perioperative preparation must be done. Al patients were treated by percutaneous vertebroplasty, percutaneous kyphoplasty and expansive pedicle screw fixation. We recorded Visual Analogue Scale (VAS) and the Oswestry Disability Index (ODI) before treatment, 3 months after treatment, as wel as sagittal index (SI) and Cobb angle of vertebral fracture before treatment, 3 days and 3 months after treatment. RESULTS AND CONCLUSION:(1) Al cases were fol owed up for 12-18 months. (2) There was no significant difference in VAS scores, ODI, SI and Cobb angle of vertebral fracture among the three groups of patients preoperatively. (3) At 3 months after treatment, there were significant differences in VAS scores and ODI in the three groups as compared with that preoperation (P<0.05). However, no significant difference in VAS and ODI was determined among intergroup comparison (P>0.05). (4) SI and Cobb angle of vertebral fracture were significantly increased;the difference was statistical y significant (P<0.05). The efficacy was similar between the percutaneous kyphoplasty and expansive pedicle screw fixation groups (P>0.05), and was better than the percutaneous vertebroplasty group (P<0.05). (5) Three kinds of treatment can effectively restore the vertebral height and intensity, relieve pain and stabilize the spine, and no significant vertebral compression was found in the short term. However, restoration of postoperative vertebral height was better in percutaneous kyphoplasty and expansive pedicle screw fixation groups than in the percutaneous vertebroplasty group. In view of their respective indications, advantages and disadvantages, the key point of raising therapeutic effect was to choose appropriate surgical procedures.