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《The Journal of Traditional Chinese Orthopedics and Traumatology》 2017-02
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Influence of balloon dilation position on curative effect and safety of percutaneous kyphoplasty for treatment of osteoporotic vertebral compression fractures

CHEN Jiande;FAN Xiaoqi;XIA Bingjiang;LING Yilong;Shaoxing Hospital of Traditional Chinese Medicine;  
Objective:To explore the influence of balloon dilation position on curative effect and safety of percutaneous kyphoplasty(PKP) for treatment of osteoporotic vertebral compression fractures(OVCF).Methods:The medical records of 47 patients with fresh singlesegment OVCF who were treated with PKP were analyzed retrospectively.The dilated balloon was placed at fracture line for 24 patients(fracture line group) and at other position for 23 patients(non-fracture line group).The injured vertebrae anterior border height pain visual analogue scale(VAS) scores,Oswestry disability index(ODI) scores and complications during the treatment period and follow- up period were compared between the 2 groups.Results:The surgery were finished successfully in all patients and no complications such as spinal cord injuries,nerve- root injuries and pulmonary embolism were found.The bone cement leakage were found in 9 patients,whlie no patient developed clinical symptoms.Anterolateral leakage(3) and leakage into intervertebral disc(2) were found in fracture line group,while anterolateral leakage(2) and leakage into intervertebral disc(2) were found in non- fracture line group.There was no statistical difference in complication incidences between the two groups(Χ~2 =0.000,P = 1.000).There was statistical difference in the injured vertebrae anterior border height between different timepoints,in other words,there was time effect(F = 117.624 P =0.000).There was statistical difference in injured vertebrae anterior border height between the 2 groups in general,in other words,there was group effect(F = 4.127 P =0.048).There was no statistical difference in injured vertebrae anterior border height between the 2 groups before the surgery(18.69 +/- 3.17 vs18.70 +/-2.96 mm f = 0.451,P = 0.654).The injured vertebrae anterior border height were higher in fracture line group compared to non-fracture line group at 3 days and 3 months after the surgery(21.56 +/- 1.57 vs 20.30 +/- 1.98 mm,t=2.127 P =0.039;21.42 +/-1.54 vs 20.14 +/-2.00 mm,t=2.145,P=0.037).There was interaction between time factor and group factor(F =9.808,P=0.003).There was statistical difference in the pain VAS scores between different timepoints,in other words,there was time effect(F =760.314 P =0.000).There was statistical difference in pain VAS scores between the 2 groups in general,in other words,there was group effect(F =4.911 P =0.032).There was no statistical difference in pain VAS scores between the 2 groups before the surgery(7.96 +/-0.86 vs7.78 +/- 0.95 points,t = 0.665 P = 0.509).The pain VAS scores were less in fracture line group compared to non- fracture line group at3 days and 3 months after the surgery(2.41 +/- 0.88 vs 2.95 +/- 0.93 points,t = 2.046,P =0.047;2.08 +/- 0.78 vs 2.56 +/- 0.73 points,t = 2.194,P = 0.033).There was interaction between time factor and group factor(F = 3.119,P = 0.049).There was statistical difference in the ODI scores between different timepoints,in other words,there was time effect(F =2 018.591 P =0.000).There was statistical difference in ODI scores between the 2 groups in general,in other words,there was group effect(F =4.168 P =0.047).There was no statistical difference in ODI scores between the 2 groups before the surgery(39.54 +/- 2.23 vs 39.13 ± +/- 1.94 points,t = 0.674 P =0.504).The ODI scores were less in fracture line group compared to non- fracture line group at 3 days and 3 months after the surgery(22.67 +/- 1.90 vs 24.35 +1-2.32 points,t =2.716 P =0.009;14.38 +/- 1.58 vs 15.61 +/- 1.44 points,t =2.793 P =0.008).There was interaction between time factor and group factor(F =4.014 P =0.021).Conclusion:The balloon dilatation at fracture sites is conducive to alleviating pain and recovering height and function of injured vertebrae with high safety in treatment of OVCF by PKP.
【Fund】: 浙江省中医药(中西医结合)重点学科建设项目(2012-XK-A32)
【CateGory Index】: R687.3;R580
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