Clinical effect of manipulative reduction combined with concave-side percutaneous kyphoplasty in the treatment of kyphoscoliosis deformity caused by acute symptomatic osteoporotic thoracolumbar fracture
Objective To study the efficacy and safety of manipulative reduction combined with concave-side percutaneous kyphoplasty(PKP)in the treatment of kyphoscoliosis deformity caused by acute symptomatic osteoporotic thoracolumbar fracture(ASOTLF).Methods The clinical data of all patients with kyphoscoliosis deformity caused by ASOTLF who were treated from January 2017 to January 2019 were retrospectively analyzed.According to the inclusion and exclusion criteria,56 patients were finally included in the study.The Visual Analogue Scale(VAS)score,Oswestry Disability Index(ODI)score,Cobb angle of scoliosis and kyphosis were compared before and after operation.Meanwhile,intraoperative bone cement leakage and new vertebral fractures during follow-up were recorded.Results All 56 patients successfully completed manipulative reduction combined with concave-side PKP.At 3 d,6 months and 1 year after operation,the VAS and ODI scores of all patients were significantly lower than those before operation,and the Cobb angles of local scoliosis and kyphosis were significantly less than those before operation(P<0.05).During the follow-up period,the patients'Cobb angle was not lost.Bone cement leakage occurred in 7.1%(4/56)of the patients during the operation,and all of them leaked to the anterior and lateral sides of the vertebral body without nerve injury.No new vertebral fracture occurred during the follow-up period.Conclusion Manipulative reduction combined with concave-side PKP is a safe and effective surgical method for the treatment of kyphoscoliosis deformity caused by ASOTLF,which can effectively relieve pain symptoms and improve the kyphoscoliosis deformity and quality of life of patients.
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