Comparison of Percutaneous Kyphoplasty and Percutaneous Pedicle Screw Fixation for the Treatment of Osteopenic Thoracolumbar Vertebral Compression Fractures

BACKGROUND: Osteoporotic vertebral compression fractures (OVCFs) have a high incidence, which have attracted wide attention from society. However, few scholars have conducted researches on osteopenic vertebral compression fractures (osteopenic VCFs). Our research has compared the clinical and imaging effects of percutaneous kyphoplasty (PKP) and percutaneous pedicle screw fixation (PPSF) in the treatment of Osteopenic thoracolumbar vertebral compression fractures (Osteopenic VCFs).METHODS: From December 2018 to September 2020, 70 patients with osteopenic VCFs who had undergone PKP and PPSF surgeries at our medical center were reviewed retrospectively. All patients were divided into PKP group (n=38) and PPSF group (n=32). Clinical data including clinical and radiological evaluation results were performed pre- and postoperatively.RESULTS: The operation time, bleeding volume, postoperative bedtime, and hospitalization period in PKP group were lower than those in PPSF group (P<0.05). The visual analogue scale (VAS) and Oswestry Disability Index (ODI) of two groups in the last follow-up were lower than those before the operation (P<0.05). On the 3rd day after the operation, VAS and ODI in PPSF group were higher than those in PKP group (P<0.05). The anterior height of injured vertebrae (AH) of two groups was recovered compared with that before the operation. Compared with two groups in each period, there was no obvious difference in AH or the height restoration of injured vertebrae (HR) (P>0.05). The anterior height ratio of injured vertebrae (AHR) of PPSF group was higher than that of PKP group after the operation (P<0.05). The kyphosis angle (KA) in PPSF group was smaller than PKP group after the operation (P<0.05). All patients in PPSF group have achieved bony healing at the last follow-up.CONCLUTIONS: Both PPSF and PKP can achieve satisfactory clinical results in the treatment of Osteopenic VCFs. The short-term clinical effect of PKP is better than that of PPSF, but the latter has better long-term results, including the correction and maintenance of vertebral height and the acquisition of osseous fusion.