[Clinical observation of effects and complications of the mid-stage in treating osteoporotic vertebral compression fracture with percutaneous kyphoplasty].
OBJECTIVE
To observe the clinical effects and complications in treating osteoporotic vertebral fractures with percutaneous kyphoplasty (PKP) and in order to found the cause and countermeasures of the complications.


METHODS
From March 2006 to March 2007, 31 patients with osteoporotic vertebral fractures were treated with unilateral percutaneous kyphoplasty. There were 11 males and 20 females, ranging in age from 54 to 91 years with the mean of 81 years. All patients were followed up for more than three years. At pre-treatment and postoperatively immediately, 1, 2, 3 years after PKP, the height of anterior vertebral body and thoracic-lumbar and back pain were respectively analyzed by imaging data and VAS scoring.


RESULTS
At pre-treatment and postoperatively immediately, 1, 2, 3 years after PKP, the height of anterior vertebral body were (0.9 +/- 0.2), (2.6 +/- 0.3), (2.6 +/- 0.2), (2.5 +/- 0.7), (2.5 +/- 0.4) cm, respectively; the VAS soring were (7.6 +/- 1.4), (2.3 +/- 0.7), (2.4 +/- 0.5), (2.8 +/- 0.3), (3.1 +/- 0.2) scores, respectively. The height of anterior vertebral body recoveried obviously after PKP (P < 0.05); following prolongation of time, the height of anterior vertebral body gradually reduced (P > 0.05). The thoracic-lumbar and back pain relieved obviously after PKP (P < 0.05); following prolongation of time, the pain gradually aggratated, but there was no significant difference (P > 0.05). At final follow up, reinforced vertebral re-fractures was found in 2 cases, adjacent vertebral fractures in 6 cases, distal vertebral fractures in 2 cases, asymptomatic degeneration of adjacent intervertebral in 5 cases.


CONCLUSIONS
PKP have definite and early effects in treating osteoporotic vertebral fractures. But in mid-stage after PKP, the height of anterior vertebral body reduce and the pain aggravate gradually, especially degenerative adjacent vertebral fracture advent. Strict choosing the candidate of the precedure, improvement of materials of perfusion and reducing of volume of bone cement maybe can decrease incidence rate of complications.
Department of Orthopaedics, Hospital of the Integration of Traditional Chinese and Western Medicine of Hangzhou, Hangzhou 310004, Zhejiang, China. hgcsanmao@163.com
Hui-Guo
HG
Chen
Zhe
Z
Zhang
Hai-Ping
HP
Liang
Qing-Zhou
QZ
Kong
Jian-Hong
JH
Chen
Ye
Y
Zhou
D000368:Aged; D000369:Aged, 80 and over; D001843:Bone Cements / Q000009:adverse effects; D000075202:Contraindications; D005260:Female; D050815:Fractures, Compression / Q000601:surgery*; D005598:Fractures, Spontaneous; D006801:Humans; D058498:Kyphoplasty / Q000009:adverse effects / Q000379:methods; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000601:surgery*; D010146:Pain / Q000209:etiology; D011183:Postoperative Complications / Q000209:etiology*; D016103:Spinal Fractures / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000187:drug effects; D016896:Treatment Outcome; D054854:Vertebroplasty / Q000379:methods
D001843:Bone Cements