Outcome analysis of surgical interventions for osteoporotic vertebral compression fractures

2011-08-15 00:54谭江威TanJiangweiDeptSpinalSurgYantaishanHospYantaiShandong264008ChinOrthopTrauma201113119124
外科研究与新技术 2011年2期

谭江威(Tan Jiangwei,Dept Spinal Surg,Yantaishan Hosp,Yantai,Shandong 264008)…∥Chin J Orthop Trauma.-2011,13(2).-119~124

Outcome analysis of surgical interventions for osteoporotic vertebral compression fractures

谭江威(Tan Jiangwei,Dept Spinal Surg,Yantaishan Hosp,Yantai,Shandong 264008)…∥Chin J Orthop Trauma.-2011,13(2).-119~124

ObjectiveTo compare the clinical outcomes of 2 surgical interventions for osteoporotic vertebral compression fractures(OVCF).MethodsSixty-five patients with OVGF from March 2005 to March 2009 were included in this clinical study.They were 25 men and 40 women,age from 58 to 81 years old(mean,73 years old).Five fractures occurred on T10,8 on T11,14 on T12,15 on L1,13 one L2,and 10 on L3.Surgical treatments were minimally invasive surgery(group A)and open surgery(group B).In group A,there were subgroup A1(Sky bone expander)and subgroup A2(balloon kyphoplasty).Group B was divided into subgroup B1(bicortical pedicle fixation)and subgroup B2(bone cement enhanced pedicle fixation).Pre-and postoperative function,symptoms,kyphosis,and complications were evaluated for the 4 groups.Neurological functions before and after surgery were compared in open surgery groups.ResultsAll procedures were performed successfully.The duration of follow-up ranged from 8 to 45 months(mean,23 months).Minimally invasive surgery obtained immediate pain relief and quick functional recovery.The visual analog scores(VAS)and functional scores one month after surgery were statistically improved in group B(P <0.05).The kyphosis in group A1 was not significantly changed after surgery(P >0.05).The neurological function improved significantly after surgery in Group B(P <0.05).Adjacent vertebral fractures occurred after surgery in both group A and group B.ConclusionPercutaneous kyphoplasty(PKP)and open reduction and fixation(ORF)are both effective treatments for OVCF,though they are differently indicated in clinic.PKP can offer instant pain relief,but Sky procedure is weak in terms of kyphotic correction.Postoperative adjacent vertebral fracture is the main complication for OVCF.16 refs,3 figs,6 tabs.

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