Comparative analysis for treatment of osteoporotic thoracolumbar fracture with percutaneous kyphoplasty and percutaneous vertebraplasty

Objective To compare the clinical effect of percutaneous kyphoplasty( PKP) and percutaneous( PVP) vertebraplasty in the treatment of osteoporotic thoracolumbar fracture. Methods 53 patients were treated with PKP( 32 patients) or PVP( 21 patients) in our hospital from March 2009 to October 2012. The operation time,X- ray exposure time,injection dose and leakage occurrence were compared between these two groups. The vertebral compression rate and the Cobb angle were evaluated by X- ray. The VAS and ODI scoring systems were employed to compare the pain and quality of life respectively in each group. Results All operations were plain sailing. The average follow- up period was 18. 2( 15 ~ 26) months. The PKP group had a much longer operation and X- ray exposure time than PVP group,but also did injection dose. The vertebral compression rate and the Cobb angle after PKP showed no statistical difference in comparison with those in follow- up,which were better than those of before operation. And for PVP group,there were no significant differences of the vertebral compression rate and the Cobb angle between preoperation and postoperation. Two leakage cases occurred in PKP and three in PVP without neurological deficiency. The VAS or ODI scores after operation presented no significant difference in comparison with those in follow- up between PKP and PVP group,but which were better than those before operation. The vertebral compression rate and the Cobb angle in the PKP group were better than that in the PVP group. Conclusion In the treatment of osteoporotic thoracolumbar fracture,PKP and PVP are both the effective surgical techniques to improve the clinical symptom. However,PKP is superior to PVP on the recovery of the vertebral body height and kyphosis after PKP is superior to those after PVP,and also in the reduction of the injective leakage rate.