The clinical effect of percutaneous kyphoplasty for the treatment of multiple osteoporotic vertebral compression fractures and the prevention of new vertebral fractures

摘要

This study aimed to investigate the clinical effect of percutaneous kyphoplasty and the precautions against adjacent vertebral refractures in the treatment of multiple osteoporotic vertebral compression fractures. 54 cases (128 vertebrae) with multiple osteoporotic vertebral compression fractures from July 2007 to December 2013 treated with percutaneous kyphoplasty were retrospectively reviewed. 36 cases of them suffered from bi-segment vertebral fractures, 16 cases with tri-segment vertebral fractures and 2 cases with quadri-segment vertebral fractures. The operative effect was evaluated by visual analogue scale (VAS) score and oswestry disability index (ODI) score. Then the reasons for adjacent vertebral refractures were analyzed and the precautions were proposed. 54 cases (128 vertebrae) were admitted with percutaneous kyphoplasty successfully. No pulmonary embolism, spinal cord injury and other serious complications were found. The follow-up took 3-33 months with the average of 12 months. There was significant difference of VAS scores and ODI scores between pre-operation and post-operation (P<0.05). Bone cement leakage occurred in 23 vertebrae, and the incidence rate was 18.0%. 8 cases sustained adjacent vertebral refractures including 3 cases in the contiguous vertebral bodies and 5 cases in the interval vertebral bodies, and the incidence rate was 14.8%. 5 cases gained fracture healing after additional percutaneous kyphoplasty procedures while the other 3 cases were healed basically after conservative treatment for three months. In conclusion, percutaneous kyphoplasty is safe and effective to treat multiple osteoporotic vertebral compression fractures. However, the risk of new adjacent vertebral fractures in the multiple osteoporotic vertebral compression fractures is higher than that in the single osteoporotic vertebral compression fracture. Timely and proper treatment can reduce refractures.