[Early clinical outcome of manual reduction combined with uni-lateral percutaneous kyphoplasty to treat osteoporotic vertebral compression fracture].

OBJECTIVE

To investigate the efficiency of manual reduction combined with uni-lateral percutaneous kyphoplasty (PKP) in treating osteoporotic vertebral compression fracture (OVCF).

METHODS

Between May 2005 and May 2009, the manual reduction combined with uni-lateral PKP was applied to treat 42 patients with OVCF (group A), and the simple uni-lateral PKP was applied to treat 43 patients with OVCF (group B) at the same period. The visual analogue scale (VAS), the vertebral height, and the Cobb angle were determined before operation, and at 3 days and 6 months after operation. In group A, there were 6 males and 36 females aged 59-93 years (76.5 years on average) with an average disease duration of 7 days (range, 3 hours to 21 days); 27 segments of thoracic vertebrae and 31 segments of lumbar vertebrae were involved, including 15 segments at mild degree, 38 segments at moderate degree, and 5 segments at severe degree according to degree classification system of compression fractures of Zoarski and Peh. In group B, there were 9 males and 34 females aged 54-82 years (75.3 years on average) with an average disease duration of 7 days (range, 1 hour to 20 days); 26 segments of thoracic vertebrae and 35 segments of lumbar vertebrae were involved, including 21 segments at mild degree, 36 segments at moderate degree, and 4 segments at severe degree according to degree classification system of compression fractures of Zoarski and Peh. There were no significant difference (P > 0.05) in sex, age, affected site, degree, and disease duration between 2 groups.

RESULTS

There was no significant difference (P > 0.05) in operative time, blood loss, or injected cement volume between 2 groups. No serious complication or death occurred in 2 groups. Cement leakage was observed in 4 cases (9.5%) of group A and in 5 cases (11.6%) of group B. The VAS scores after operation significantly decreased in 2 groups (P < 0.01). At 3 days and 6 months after operation, the VAS scores in group A were significantly lower than those in group B (P < 0.05). The postoperative compression rates of affected vertebral body in 2 groups significantly decreased (P < 0.01). The compression rates of affected vertebral body at 3 days and 6 months after operation, and the height recovery rate at 3 days after operation in group A were superior to those in group B (P < 0.05). The postoperative Cobb angles in 2 groups were significantly diminished (P < 0.01). The Cobb angles at 3 days and 6 months after operation, and the recovery rate at 3 days after operation in group A were superior to those in group B (P < 0.05).

CONCLUSION

The clinical efficiency of the manual reduction combined with unilateral PKP is superior to that of simple uni-lateral PKP in treatment of severe OVCF.