| Abstrakt: |
BACKGROUND: Percutaneous vertebral body stenting system (VBS) can alleviate patients pain, recover the height of vertebral body, and correct local kyphosis, but there is no definite clinical study to show that it has obvious advantages over percutaneous kyphoplasty (PKP). OBJECTIVE: To compare the short-term effect of VBS versus PKP in the treatment of osteoporotic vertebral compression fracture. METHODS: Forty patients with osteoporotic vertebral compression fracture who received VBS or PKP between January 2017 and December 2018 in the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine were included in this study. They were divided into a VBS group (n=15) and a PKP group (n=25) according to surgery method. According to whether fluoroscopic operation was performed in retroextension position, two subgroups were designated: VBS retroextension group (n=7) and PKP retroextension group (n=14). RESULTS AND CONCLUSION: Compared with the PKP group, the amount of bone cement injected into the vertebra was greater in the VBS group (P < 0.05). There were no significant differences in operation time, intraoperative blood loss, and leakage rate of cement between PKP and VBS groups (P > 0.05). Compared with preoperative situations, Visual Analogue Scale score was significantly decreased after surgery in both VBS and PKP groups, and further decreased at the last follow-up (P < 0.05). The height of anterior edge of the injured vertebra, the height of middle part of the injured vertebra and the ratio of the height of the anterior edge of injured vertebra to adjacent vertebra were significantly increased after surgery in both VBS and PKP groups (P < 0.05). In both VBS and PKP groups, the Cobb angle of vertebral compression was significantly decreased after surgery compared with before surgery (P < 0.05). After surgery, the Cobb angle of vertebral compression in the VBS group was smaller than that in the PKP group (P < 0.05). In the VBS group, local Cobb angle after surgery was significantly decreased compared with that before surgery (P < 0.05). There were no significant differences in operation time, intraoperative blood loss, amount of bone cement, bone cement leakage, cinical efficacy (VAS score), imaging evaluation {height of anterior edge of injured vertebra, height of middle part of injured vertebra, height ratio of anterior edge of injured vertebra to adjacent vertebra, Cobb angle of vertebral compression and local Cobb angle between VBS retroextension and PKP retroextension groups (P > 0.05). These results suggest that VBS and PKP are effective in the treatment of osteoporotic vertebral compression fractures. VBS can better correct compression kyphosis deformity when more bone cement is injected. The difference of therapeutic efficacy between two surgical approaches can be reduced with proper surgical position, keeping the surgical segment in the retroextension position. [ABSTRACT FROM AUTHOR] |
