[Comparison of therapeutic effects of conventional puncture technique and target puncture technique in the treatment of osteoporotic vertebral compression fractures in elderly by vertebroplasty].

Abstract

Objective: To explore clinical efficacy of conventional puncture technique and precise target puncture technique in percutaneous vertebroplasty (PVP) for the treatment of osteoporotic vertebral compression fractures (OVCFs) in elderly.

Methods: From January 2016 to December 2019, 64 elderly patients with OVCFs were treated by PVP technique. According to t different puncture methods, they were divided into conventional puncture technique group (conventional group) and precise target puncture technique group (target group). The conventional group consisted of 31 cases, included 4 males and 27 females, aged from 63 to 93 years old with an average of (75.58±7.98) years;15 patients with thoracic vertebrae and 23 patients with lumbar vertebrae. There were 33 patients in target group, included 4 males and 29 females;aged from 62 to 93 years old with an average of (74.61±8.17) years old;19 patients with thoracic vertebrae and 27 patients with lumbar vertebrae. Operation time, hospital stay, bone cement leakage, number of patients with bone cement leakage, pain visual analogue scale (VAS), and the height of anterior vertebral margin between two groups were observed and compared.

Results: Both of two groups were followed up, and the follow-up period for conventional group ranged from 6 to 8 months with an average of (6.23±1.51) and for target group ranged from 6 to 10 months with an average of (6.76±1.11) months, there was no statistically significant difference in follow-up period between two groups (P>0.05). There were no statistically significant differences in operation time, hospital stay, bone cement leakage, bone cement injection volume, and VAS before operation and 6 months after operation between two groups (P>0.05). VAS of target group decreased from (7.36±0.49) points before operation to (1.64±0.49), (1.30±0.47), and (0.82±0.39) points respectively at 1 day, 1 month, and 6 months after operation;VAS of control group decreased from (7.42±0.50) before operation to (1.97±0.18), (1.64±0.49), and (0.94±0.44) respectively at 1 day, 1 month, and 6 months after operation;the differences were all statistically significant (P<0.05);VAS of target group was lower than that of conventional group at 1 day and 1 month after operation (P<0.05). Postoperative anterior vertebral height at 3 days and 6 months in target group were (24.04±5.40) mm and (23.71±2.65) mm respectively, while in conventional group were (23.89±4.00) mm and (22.21±3.63) mm respectively;and there were no statistically significant difference in anterior vertebral height between two groups at 3 days after operation (P>0.05);postoperative anterior vertebral height of target group was higher than that of conventional group at 6 months, and the difference was statistically significant (P< 0.05).

Conclusion: PVP puncture technique not only retains advantages of traditional PVP, such as short operation time, short hospital stay, and immediate pain relief, but also has better efficacy in reducing pain intensity and preventing short-term loss of vertebral height. It is a preferable treatment option for elderly patients with OVCFs.