Percutaneous Kyphoplasty in the Treatment of Osteoporotic Vertebral Compression Fractures

［Abstract］Objective　To explore the application value of percutaneous kyphoplasty（PKP）in the treatment of osteoporotic vertebral compression fractures（OVCF）and the prevention of complications．Methods　From June 2006 to January 2009，a totally of 97 vertebra with OVCF in 68 patients were treated by using domestic PKP tool system．There were 21 males and 47 females，with the age of 62～82 years．The puncture point was located between costal fovea of the transverse process and superior articular process for thoracic vertebra，and in lateral upper edge of the pedicle projection for lumbar vertebra．With the patients in prone position，the puncture needle was inserted into the fractured vertebral body via the lateral edge of pedicle under C-arm guidance．After the location of neddle tip was confirmed，the sugery was carried out according to the operative procedure．Results　The operations were successful in all patients．The bone cement leaked into intervertebral disc in 2 cases，paravertebral space in 2 cases and spinal canal in 4 cases of 7 vertebra. The incidence of complication was 11.76%．1 case had got a pain in the anterolateral thigh after ambulation on the second postoperative day，which was relieved by symptomatic treatment 6 days later．2 cases which suffered from decreased blood pressure and weak pulse during the operation，were improved after treatment. Postoperative fever was found in 3 cases．All patients began to ambulate on the second day after operation and were followed up for 3-18 months．The average height of severe collapsed vertebra is increased from 1.58cm to 2.13cm．Compared with the preoperative measurement，Cobb angle was reduced 12.3 ° ± 3.4 on average．Conclusions　The PKP in the treatment of OVCF can quickly relieve pain，recover the height of fractured vertebra，improve kyphosis and life quality．The measurement of needle angle，observation of vertebra with MRI and 3DCT，monitoring of bone cement injection whole process can effectively reduce the incidence of complications.