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A Contrastive Study on Unipedicular or Bipedicular Approach Balloon Kyphoplasty in the Treatment of Osteoporosis Vertebral Compression Freh Fractures

Author: YangFengDong
Tutor: ZhengLianJie
School: Dalian Medical University
Course: Surgery
Keywords: Vertebral fracture percutaneous kyphoplasty osteoporosis
CLC: R687.3
Type: Master's thesis
Year: 2010
Downloads: 68
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Abstract

Objective:The purpose of this study was to explore the efficacy and safety differences between unilateral and bilateral approaches balloon angioplasty treatment of osteoporosis vertebral compression fresh fractures in of the elderly.Methods:we chose 38 osteoporosis vertebral compression fresh fractures patients who accept the operation of angioplasty convex vertebral from chifeng college hospital from february 2005 to january 2009.All those patients were gotten follow-up atleast 10 months.The thoracolumbar compression fractures in 38 patients was single vertebral fracture. We divided 38 patients to two differents groups according to the operation was unilateral or bilateral approaches.We got 18 cases in unilateral approaches group, male 5, female18,age from 60to 85, average 72.4.20 cases in bilateral approaches, male 6, female14,age from 62to 83, average 71.6.All patients under the "C" type arm X-ray machine guided percutaneous finish operation.All patients were observed with the pain relief and recovery, vertebral body height after protrusion deformity correction vertebral bone cement leakage, etc. Finally collected data and made ionstatistical analysis.Results:All patients were successfully completed the operation. Surgical time:The unilateral group 45 to 65 minutes, the average 56.4 minutes, The bilateral group 85 to 105 minutes, the average 93.8 minutes. The number of perspective of unilateral group:18 to 29 times, the average 21.4 times, Bilateral group:35 to 48 times, the average 40.6 times. Two groups of postoperative got pain significantly relief.VAS score of unilateral group improved from 7.4±1.6 to 2.2±1.5 before and after operation,and was 2.7±1.3 at six months after surgery, VAS score of bilateral group improved from 7.6±1.5 to 2.3±1.3 before and after operation,and was 2.6±1.2 at six months after operation,there was significant difference befor and after operation and there was significant difference befor operation and six months after operation(P< 0.01). the comparison between the two groups was no statistically significant difference (P> 0.05).The case of Spinal deformity correction:Cobb angle of unilateral group improved from 28.8°±3.8°to 12.3±1.8°before and after operation,and was 14.5°±1.9°at six months after operation, bilateral group improved from 29.2°±4.3°to 13.5°±1.4°before and after operation,and was14.9°±1.6°at six months after operation,there was significant difference befor and after operation and there was significant difference befor operation and six months after operation(P< 0.01). the comparison between the two groups was no statistically significant difference (P> 0.05). Recovery of height of the injured anterior vertebral body(cm):height of the injured anterior vertebral body of unilateral group improved from 1.6±0.3 to 2.4±0.2 before and after operation,and was 2.3±0.3 at six months after operation, bilateral group improved from 1.7±0.3to 2.5±0.2 before and after operation,and was2.4±o.0.3at six months after operation,there was significant difference befor and after operation and there was significant difference befor operation and six months after operation(P< 0.01). the comparison between the two groups was no statistically significant difference (P> 0.05).Recovery of height of the injured medial vertebral body(cm):height of the injured medial vertebral body of unilateral group improved from 1.5±0.2to2.4±0.3 before and after operation,and was 2.4±0.3 at six months after operation, bilateral group improved from 1.5±0.4 to 2.6±0.3 before and after operation,and was2.5±0.2at six months after operation,there was significant difference befor and after operation and there was significant difference befor operation and six months after operation(P< 0.01). the comparison between the two groups was no statistically significant difference (P> 0.05).In the unilateral group,there was one case happened bone cement leakage in vertebral body lateral,in the bilateral group,there was one case happened bone cement leakage in vertebral body lateral, there was one case happened bone cement leakage in front of vertebral body.There was no complications of pulmonary embolism、cerebral embolism、spinal cord injury and nerve root injury.Patients were followed up 6-13 months and 10.3 months on average. no sore aggravating, no late-occurred nerve damage is found, no vertebral body height loss is found.Conclusion:Balloon Kyphoplasty is a Safe and effective minimally invasive treatment to the elderly Osteoporotic vertebral compression fractures,to treatmentof elderly osteoporosis vertebral fractures, unipedicular and bipedicular approach Balloon Kyphoplasty is similar in the way of deformity correction、vertebral body height recovery、pain relief functional recovery, unipedicular approach Balloon Kyphoplasty in the treatment of Osteoporosis Vertebral Compression Fractures can greatly reduce the operation time and radiation exposure, reduce trauma, reduce the medical costs, it is worthy to be popularized.

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CLC: > Medicine, health > Surgery > Orthopaedic Surgery ( movement system diseases,orthopedic surgery ) > Orthopedic surgery and surgery > Bone surgery
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