The role of low-back soft tissue after vertebroplasty and kyphoplasty for spinal osteoporotic fractures

Abstract

Objective To investigate the effect of soft tissue on the posterior lumbar spine after percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) for spinal osteoporotic fractures. Methods From January 2015 to December 2016, 52 patients with thoracolumbar osteoporotic fracture in our hospital underwent PKP or PVP. According to their fat suppression sequence (FSE) on Magnetic Resonance Imaging (MRI) , they were divided into FSE positive and FSE negative groups. The FSE negative group had 38 patients, 9 males and 29 females with a mean age of 75.1±6.0 years; the FSE positive group had 14 patients, 4 males and 10 females with a mean age of 73.9±5.8 years. The 2 groups were compared in terms of visual analogue scale (VAS) for lying on bed and standing at the 1, 3 and 7 days after surgery and painless ambulation at the 3 time points as well. Results There were no significant differences between the 2 groups in age, gender or responsible vertebrae distributions. When the patients were lying on bed, their VAS scores at the 1, 3 and 7 days after surgery were 4.1±1.7, 3.0±0.9 and 1.0±0.8 for the FSE negative group, and 4.8±1.0, 3.0±0.7 and 1.3±0.9 for the FSE positive group; when the patients were standing, their VAS scores at the 1, 3 and 7 days after surgery were 4.2±1.1, 3.2±0.7 and 1.9±0.7 for the FSE negative group, and 5.4±1.1, 4.0±1.0 and 2.3±0.5 for the FSE positive group. The VAS scores for standing at the 1 and 3 days after surgery for the FSE negative group were significantly lower than those for the FSE positive group (P 0.05) . At the 1, 3 and 7 days after surgery, there were respectively 22, 37 and 38 patients in the FSE negative group who accomplished painless ambulation and there were respectively 3, 9 and 14 patients in the FSE positive group who accomplished painless ambulation. A significantly larger proportion of the patients in the FSE negative group accomplished painless ambulation than in the FSE positive group (P<0.05) . At 7 days after surgery, all the patients in the 2 group accomplished painless ambulation. Conclusions The soft tissue of the lower back may play an important role after PKP and PVP, for fine soft tissue can reduce time for lying on bed and foster surgical efficiency. The VAS scores for standing may be more significant than those for lying on bed in prediction of ambulant time. Key words: Soft tissue injuries; Low back pain; Vertebroplasty; Body position