Abstract
BackgroundTo explore the analgesic efficacy of extracorporeal shock wave (ESW) combined with percutaneous vertebroplasty (PVP) after reduction in overextension position in the treatment of osteoporotic thoracolumbar compression fractures in postmenopausal women.MethodsThe data of postmenopausal women with osteoporotic thoracolumbar compression fracture admitted in our department from January 2017 to October 2019 were analyzed retrospectively. They were divided into groups of unipedicular percutaneous kyphoplasty (U-PKP n = 21), bipedicular PKP (B-PKP n = 20), and ESW combined with PVP after reduction in overextension position (EP-PVP n = 18). The improvement of pain and vertebral height in three groups was compared.ResultsPostoperative compression rate and Cobb angle of vertebral fractures in the three groups were all lower than those before surgery, and the differences between pre-operation and post-operation were statistically significant (P < 0.05). The visual analog scale (VAS) and Oswestry dysfunction index (ODI) scores of the three groups decreased significantly after the operation (P < 0.05). The ODI scores of the EP-PVP group in the third months after the operation were significantly improved compared with the other two groups, and the difference was statistically significant (P < 0.05).ConclusionsIn our small-sample study, all three treatment schemes can treat osteoporotic compression fracture of thoracolumbar vertebrae in postmenopausal women, relieve pain, and improve quality of life. ESW combined with PVP after reduction in overextension position could achieve a good vertebral reduction rate and improve kyphosis, and may reduce the application of analgesic drugs.
Highlights
To explore the analgesic efficacy of extracorporeal shock wave (ESW) combined with percutaneous vertebroplasty (PVP) after reduction in overextension position in the treatment of osteoporotic thoracolumbar compression fractures in postmenopausal women
The treatment included unipedicular piercing percutaneous kyphoplasty (PKP) (U-PKP), bipedicular piercing PKP (B-PKP), and ESW combined with Percutaneous vertebroplasty (PVP) after reduction in overextension position (EP-PVP)
Comparison of postoperative complications The X-ray is taken immediately after the operation which indicated that bone cement leakage occurred in 2 vertebrae of the B-PKP group, in 2 vertebrae of the U-PKP group, and in 4 cases in the EP-PVP group, with no statistically significant difference (P > 0.05)
Summary
To explore the analgesic efficacy of extracorporeal shock wave (ESW) combined with percutaneous vertebroplasty (PVP) after reduction in overextension position in the treatment of osteoporotic thoracolumbar compression fractures in postmenopausal women. Because of the lack of estrogen in postmenopausal women, leading to accelerated loss of sclerostin and decreasing bone strength, the proportion of osteoporotic fractures increases It has become one of the most serious public health problems affecting postmenopausal women’s physical health and quality of life [3]. PVP after reduction in overextension position can help to restore the height of the vertebral body and restore the sagittal balance of the spine, and the bone cement dispersion is more uniform, with lower cost and relatively simple operation, which can achieve good clinical treatment results [6]. ESW provides a new idea to relieve osteoporosis pain
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