Early clinical outcome of vesselplasty and kyphoplasty in treatment of osteoporotic vertebral compression fractures

doi:10.3877/cma.j.issn.2096-0263.2018.04.003

Abstract

Abstract:

Objective

To compare the early clinical outcomes of vesselplasty and kyphoplasty in the treatment of osteoporotic vertebral compression fractures.

Methods

A retrospective analysis was performed in 114 patients with OVCFs underwent vesselplasty (59 cases, 68 vertebras) and kyphoplasty (55 cases, 66 vertebras) in Hangzhou Normal University affiliated Hospital between June 2015 to December 2016. Preoperative vertebral compression, vertebral height restoration, cement leakage, the shape of cement, the volume ratio of cement were compared between two groups. The Clinical effect were evaluated using the visual analogue scale (VAS) and Oswestry disability index (ODI).

Results

All 57 cases received an average of (3.7±0.9) months follow-up (3-6 months). Compared with preoperative data, VAS and ODI score were improved significantly at 1 day after operation in both groups (PKP: Z=-10.143, F=1768.418, P<0.05; vesselplasty: Z=-10.027, F=2192.838, P<0.05). And at the last follow-up, the VAS and ODI score were improved significantly compared to the postoperative 1 day after operation in both groups (PKP: Z=-5.708, F=204.339, P<0.05; vesselplasty: Z=-5.691, F=147.729, P<0.05). PKP group associated with a higher rate of cement leakage than the vesselplasty group (27.9% vs. 13.6%, χ²=4.146, P<0.05) and a lower rate of cement volume ratio [(22±5)% vs. (24±4)%, t=-2.659, P<0.05]. In the aspect of cement shape, the dominant one in PKP group were mixed type (60.3%) and trabecular type (39.7%), while the vesselplasty group were mixed type (78.8%) and mass type (15.1%), the difference had statistically significant (χ²=34.271, P<0.05). Four patients (1 case in PKP group and 3 cases in vesselplasty group) had vertebra fractures during the follow-up period, the inter-group comparison has no significant differences.

Conclusions

Vesselplasty can rapidly relieve pain, improve mobility, restore the height of vertebral in patients with OVCFs. It is suitable for complex vertebral fractures as reducing the incidence of cement leakage contrasting to PKP.

Key words: Osteoporosis, Fractures, compression, Kyphoplasty, Bone filling mesh-container

Yaming Xie, Guosheng Xie, Meng Lin, Zhiqing Chen. Early clinical outcome of vesselplasty and kyphoplasty in treatment of osteoporotic vertebral compression fractures[J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2018, 04(04): 202-208.

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Figures/Tables 7

References 25

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组别	例数	性别（例，男/女）	年龄（岁，±s）	骨密度（S，±s）	骨折位置（例）			Genant骨折类型（例）			终板破损（例，有/无）	周围皮质破损（例，有/无）	椎体内裂隙（例，有/无）
组别	例数	性别（例，男/女）	年龄（岁，±s）	骨密度（S，±s）	胸段	胸腰段	腰段	Ⅰ型	Ⅱ型	Ⅲ型	终板破损（例，有/无）	周围皮质破损（例，有/无）	椎体内裂隙（例，有/无）
PKP组	59	13/46	76±8	-2.81±0.31	2	53	13	15	38	15	18/50	11/57	14/54
网袋成形术组	55	11/44	76±7	-2.76±0.24	3	49	14	13	33	20	14/52	14/52	11/55
统计/值	?	χ²=0.071	t=-0.827	t=-0.996	χ²=0.364			χ²=1.108			χ²=0.509	χ²=0.56	χ²=0.339
P值	?	0.737	0.411	0.322	0.834			0.554			0.475	0.454	0.56

组别	例数	性别（例，男/女）	年龄（岁，±s）	骨密度（S，±s）	骨折位置（例）			Genant骨折类型（例）			终板破损（例，有/无）	周围皮质破损（例，有/无）	椎体内裂隙（例，有/无）
组别	例数	性别（例，男/女）	年龄（岁，±s）	骨密度（S，±s）	胸段	胸腰段	腰段	Ⅰ型	Ⅱ型	Ⅲ型	终板破损（例，有/无）	周围皮质破损（例，有/无）	椎体内裂隙（例，有/无）
PKP组	59	13/46	76±8	-2.81±0.31	2	53	13	15	38	15	18/50	11/57	14/54
网袋成形术组	55	11/44	76±7	-2.76±0.24	3	49	14	13	33	20	14/52	14/52	11/55
统计/值	?	χ²=0.071	t=-0.827	t=-0.996	χ²=0.364			χ²=1.108			χ²=0.509	χ²=0.56	χ²=0.339
P值	?	0.737	0.411	0.322	0.834			0.554			0.475	0.454	0.56

组别	例	VAS[分，M（Q_R）]			Z值	P值	ODI（%，±s）			F值	P值
组别	数	术前	术后1 d	末次随访	Z值	P值	术前	术后1 d	末次随访	F值	P值
网袋成形术	55	8（1）	3（2）^#	2（1）^#*	-10.143	<0.05	78±6	28±5^#	20±4^#*	1768.418	<0.05
PKP	59	8（1）	3（1）^#	2（1）^#*	-10.027	<0.05	77±5	28±4^#	21±3^#*	2192.838	<0.05
统计值	?	Z=-0.328	Z=-1.399	Z=-0.571	?	?	F=-1.322	F=0.443	F=1.339	?	?
P值	?	0.743	0.162	.0568	?	?	0.189	0.659	0.183	?	?

组别	例	VAS[分，M（Q_R）]			Z值	P值	ODI（%，±s）			F值	P值
组别	数	术前	术后1 d	末次随访	Z值	P值	术前	术后1 d	末次随访	F值	P值
网袋成形术	55	8（1）	3（2）^#	2（1）^#*	-10.143	<0.05	78±6	28±5^#	20±4^#*	1768.418	<0.05
PKP	59	8（1）	3（1）^#	2（1）^#*	-10.027	<0.05	77±5	28±4^#	21±3^#*	2192.838	<0.05
统计值	?	Z=-0.328	Z=-1.399	Z=-0.571	?	?	F=-1.322	F=0.443	F=1.339	?	?
P值	?	0.743	0.162	.0568	?	?	0.189	0.659	0.183	?	?

组别	椎体数	伤椎前缘高度（mm，±s）			骨水泥形态[例（%）]			骨水泥容积率（%，±s）
组别	椎体数	术前	术后1 d	末次随访	团块型	骨小梁型	混合型	骨水泥容积率（%，±s）
PKP组	68	18.5±2.7	21.8±2.3^#	19.4±2.2^#*	0	27（39.7）	41（60.3）	22±5
网袋成形术组	66	18.4±2.6	21.9±2.5^#	20.1±2.5^#*	10（15.1）	4（6.1）	52（78.8）	24±4
统计值	?	t=0.165	t=-0.423	t=-1.820	χ²=34.271			t=-2.659
P值	?	0.869	0.673	0.071	0.000			0.009

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