Percutaneous vertebroplasty combined with pedicle screw in treating osteoporotic vertebral fracture
Objective To compare and analyze the application value of percutaneous vertebroplas-ty(PVP)combined with pedicle screw internal fixation and simple percutaneous kyphoplasty(PKP)on os-teoporotic vertebral compression fracture(OVCF).Methods The clinical data of 98 patients with OVCF in Department of Orthopedics of Affiliated Hospital of Nantong University from January 2020 to December 2021 were collected.Among the patients,46 cases underwent PVP+pedicle screw internal fixation(PVP+internal fixation group,including 20 males and 26 females)and 52 cases received simple PKP(PKP group,including 24 males and 28 females).All patients were followed up for ≥12 months after sur-gery.The surgical related indicators were recorded in both groups,and the changes in injured vertebrae pa-rameters and American Spinal Injury Association(ASIA)were observed before surgery and at 1 week and 12 months after surgery,and the postoperative complications were evaluated.Repeated measurement analy-sis of variance and LSD-t test were used for measurement data conforming to normal distribution.Enumera-tion data were analyzed by Chi-square test or Fisher's exact test.Results The surgical time in PVP+in-ternal fixation group was significantly longer than that in PKP group p(103.47±12.55)min vs.(90.21±10.37)min,t=5.725,P＜0.05],and the intraoperative blood loss was more than that in PKP group[(114.57±16.20)ml vs.(105.61±13.44)ml,t=2.991,P＜0.05],and comparison of bone cement leakage rate in the two groups(0 vs.1.92％)showed P＞0.05 in Fisher's exact test.There was no statis-tically significant difference in the bone cement injection volume between the two groups[(4.10±0.76)ml vs.(4.03±0.65),t=0.481,P＞0.05].The kyphosis Cobb angles in PVP+internal fixation group were smaller than those in PKP group at 1st week and 12th month after surgery[(3.35±0.72)° vs.(4.24±0.75)°,(3.56±0.68)° vs.(4.45±0.70)°,t=5.973,6.366,P＜0.05].The vertebral com-pression rates in PVP+internal fixation group at 1st week and 12th month after surgery were lower than those in PKP group[(5.01±0.49)％vs.(6.71±0.40)％,(5.14±0.48)％vs.(6.99±0.42)％,t=18.897,20.350,P＜0.05].The ASIA grading of the two groups recovered to grade E at 12th month after surgery.No complications such as screw loosening,fracture,refracture of injured vertebra and adjacent vertebra fracture were found in both groups during postoperative follow-up period.Conclusion Simple PKP has shorter surgical time and less blood loss,but pedicle screw internal fixation combined with PVP has more ideal vertebral height recovery than simple PKP.
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