The correlation between vertebral wedge-shaped changes in X-ray imaging at supine and standing positions and the efficacy of operative treatment of thoracolumbar spinal fracture in the elderly

摘要

Study design:By analyzing a large number of surgical patients, we identified the roles of wedge-shaped changes in related surgeries.Objectives:To illustrate the relevance of vertebral wedge-shaped changes in X-ray imaging at supine and standing positions in patients with percutaneous kyphoplasty as well as the postoperative effect.Setting:All patient data were collected from a hospital in China.Methods:Between June 2006 and May 2010, 77 surgical patients (9 men and 68 women) with wedge-shaped compression fractures were retrospectively analyzed. Patients were divided into group A (ΔWR≥2.5%) and group B (ΔWR<2.5%) according to the dynamic changes in the percentage of vertebral body wedge-shaped variable ratio (WR) at supine and standing positions. The intensity of back pain in different positions pre- and postoperatively was evaluated with a visual analog pain scale (VAS).Results:The WRs in both standing and supine positions were significantly reduced by kyphoplasty in both groups A and B. In agreement with the improvement in WRs, the VAS was significantly decreased in three positions for patients in group A and in turning over and standing position for patients in group B. With respect to ΔWR changes, group B revealed significantly lower values compared with group A preoperatively (P<0.001), but there was no significant difference between groups A and B postoperatively and at 1-month follow-up (P=0.179 and P=0.558, respectively).Conclusions:Improvement in symptoms after kyphoplasty is better in patients with wedge-shaped changes in supine and standing positions, and the efficacy of height restoration of the spine would be better in unstable vertebrae by balloon dilatation.