Comparison of vertebroplasty and conservative treatment for thoracolumbar fracture
SU Zhi-yan
CHEN Yong-chun
CHEN Xin-jiang
Abstract：Objective To compare the effects of vertebroplasty and conservative treatment for thoracolumbar fracture. Methods We retrospectively reviewed 122 vertebral fracture cases from January 2010 to October 2015 in our department. Seventy-four cases were listed in the vertebroplasty group and 48 cases were in the conservative group. X-ray was utilized to access the recovery during the follow-up. Visual analogue scale ( VAS ) was used to access the severity of the back pain and Oswestry disability index ( ODI ) to access lumbar functions. Data analysis was done by SPSS 19.0. Results The two groups showed no differences in age, gender, body mass index ( BMI ), bone mineral density ( BMD ), high blood pressure, diabetes mellitus and follow-up time ( P > 0.05 ). The 2 groups both got better VAS ( vertebroplasty group: 1 month follow-up 2.27 ± 0.76, final follow-up 1.35 ± 1.08; conservative group: 1 month follow-up 2.71 ± 0.90, final follow-up 2.00 ± 0.80 ) and ODI ( vertebroplasty group: 1 month follow-up 13.41 ± 3.41, final follow-up 6.49 ± 2.23; conservative group: 1 month follow-up 26.17 ± 5.27, final follow-up 13.04 ± 2.12 ), which showed significant differences comparing to pre-treatment values ( vertebroplasty group VAS 6.74 ± 1.05, ODI 39.42 ± 4.95; conservative group VAS 6.44 ± 1.13, ODI 38.19 ± 5.16) ( P < 0.05 ). Pre-treatment VAS and ODI showed no inner-group differences ( P > 0.05 ). However, the vertebroplasty group showed lower VAS ( 2.27 ± 0.76, 1.35 ± 1.08 ) and ODI ( 13.41 ± 3.41, 6.49 ± 2.23 ) than the conservative group ( 2.71 ± 0.90, 2.00 ± 0.80; 26.17 ± 5.27, 13.04 ± 2.12 ) at 1 month and final follow-up ( P < 0.05 ). The vertebroplasty patients could return to normal life earlier ( 3.61 ± 0.45 ) weeks than the conservative group ( 10.23 ± 1.72 ) weeks ( P < 0.05 ). At the final follow-up, anterior vertebral restoration of the vertebroplasty group was better ( 13.4 ± 1.3 ) % than that of the conservative group ( 4.2 ± 0.7 ) % ( P < 0.05 ). The improvement rate was negatively correlated with VAS score at the last follow-up ( r = -0.32, P < 0.05 ). Adjacent fracture rate was higher in the vertebroplasty group ( 12.2% ) than in the conservative group ( 2.1% ) ( P < 0.05 ). No complications of neurological injury, infection, bedsore, deep venous thrombosis or death occurred during the follow-up. Conclusions Vertebroplasty can effectively restore the height of the fractured vertebra, maintaining the curvature of the thoracolumbar spine. It can reduce back pain more effectively than the conservative treatment. However, adjacent vertebral fracture rate is higher in the vertebroplasty group.
Keywords：Spinal fracturesThoracic vertebraeLumbar vertebraeVertebroplastyBack painLow back pain
Publication Date：2017-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 747-751 )