[Influence on adjacent lumbar bone density after strengthening of T12, L1 segment vertebral osteoporotic compression fracture by percutaneous vertebroplasty and percutaneous kyphoplasty].
OBJECTIVE
To observe the influence on adjacent lumbar bone density after strengthening of T12, L1 segment vertebral osteoporotic compression fracture by percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) in postmenopausal female.


METHODS
Between January 2008 and June 2011, 59 patients with T12, L1 segment thoracolumbar osteoporotic compression fracture were treated with PVP in 29 cases (PVP group) and PKP in 30 cases (PKP group), who were in accordance with the inclusion and exclusion criteria. No significant difference was found in gender, duration of menopause, disease druation, causes of injury, fractured vertebral body, and vertebral fracture classification between 2 groups (P > 0.05). The kyphosis Cobb angle of surgical area was measured at preoperation, 1 week after operation, and last follow-up; the lower three lumbar spine bone mineral density (BMD) of the surgical area, the femoral neck BMD, and body mass index (BMI) of patients were measured at perioperative period and last follow-up to find out the statement of anti-osteoporosis; FRAX online tools were used to evaluate the probability of major osteoporotic fracture and hip fracture of the next 10 years.


RESULTS
The average follow-up was 25.5 months (range, 12-48 months) in 2 groups. There was significant difference in kyphosis Cobb angle of T12, L1 between preoperation and last follow-up in 2 groups (P < 0.05); the Cobb angle of PKP group was significantly less than that of PVP group at 1 week after operation and last follow-up (P < 0.05). No significant difference was found in BMI between 2 groups, and between perioperative period and last follow-up in the same group (P > 0.05). The lower three lumbar spine BMD of the surgical area and its T value at last follow-up was improved significantly when compared with BMD at perioperative period (P < 0.05); there was no significant difference in the lower three lumbar spine BMD and its T value between 2 groups at perioperative period (P > 0.05), but significant difference was found between two groups at last follow-up (P < 0.05). Difference was not significant in the femoral neck BMD and its T value between 2 groups, and between perioperative period and last follow-up in the same group (P > 0.05). The probability of major osteoporotic fracture and hip fracture of the next 10 years was not significantly different between 2 groups and between perioperative period and last follow-up in the same group (P > 0.05).


CONCLUSIONS
The increased BMD of adjacent lumbar spine can improve the strength of the vertebral body and reduce the incidence of adjacent vertebral fracture in patients with T12, L1 segment vertebral osteoporotic compression fracture after PVP/PKP, and PKP is superior to PVP increasing BMD of adjacent lumbar spine.
Department of Orthopedics, First Affiliated Hospital of Bengbu Medical College, Bengbu Anhui, 233004, P.R.China.
Changchun
C
Zhang
Kun
K
Zhu
Jiansheng
J
Zhou
Xinshe
X
Zhou
Guoqi
G
Niu
Min
M
Wu
Chen
C
Shao
D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D005260:Female; D050815:Fractures, Compression / Q000209:etiology / Q000473:pathology / Q000601:surgery; D006801:Humans; D058498:Kyphoplasty; D008159:Lumbar Vertebrae / Q000293:injuries / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000150:complications; D058866:Osteoporotic Fractures / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications; D011446:Prospective Studies; D016103:Spinal Fractures / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000293:injuries / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome; D054854:Vertebroplasty