Comparative study of percutaneous vertebroplasty and kyphoplasty in the treatment of osteoporotic vertebral compression fractures.

摘要

OBJECTIVE: To compare the therapeutic effect of percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) in the treatment of osteoporotic vertebral compression fractures (VCFs). METHODS: A total of 244 patients with VCFs were treated by PVP or PKP and 192 had follow-up for at least 1 year. Clinical outcomes were determined by pain Visual Analog Scale (VAS) and Short Form 36 Health Survey (SF-36). Preoperative and postoperative radiographic assessment included measurement of posterior and anterior vertebral body height (AH and PH), as well as the kyphotic angle by the Cobb method. RESULTS: A total of 192 cases had follow-up for at least 1 year and 52 cases lost. The average amount of polymethylmethacrylate (PMMA) cement introduced per vertebra was 3.4 +/- 1.5 ml in PVP and 4.5 +/- 0.8 ml in PKP (P < 0.05). All patients subjectively reported immediate relief of their typical fracture pain, and the mean VAS decreased significantly from presurgery to postsurgery during the 1-year of follow-up. The RP, BP and GH dimensionality values of SF-36 in PKP were higher than PVP (P < 0.05). The improvement on AH was 11.13 +/- 5.68% in PVP and 21.46 +/- 9.87% in PKP (P < 0.01); on PH was 2.25 +/- 1.36% in PVP and 7.57 +/- 2.49% in PKP (P < 0.01). The average improvement in the kyphotic angle after the procedure was 5.21 +/- 2.33 degrees in PVP and 11.69 +/- 5.18 degrees in PKP (P < 0.01). CONCLUSIONS: PVP and PKP have the ability of reducing pain in osteoporotic VCF patients. The correction of kyphotic deformity and restoration of the anterior vertebral body heights associated with osteoporotic VCFs was better in PKP.