A comparative study of percutaneous kyphoplasty and conservative therapy on vertebral osteoporotic compression fractures in elderly patients

Objective: To compare the therapeutic efficacy of percutaneous kyphoplasty (PKP) with that of conservative treatment in elderly patients with osteoporotic vertebral compression fractures (OVCFs). Methods: A total of 80 elderly patients with osteoporotic vertebral compression fractures admitted to our hospital from January, 2013 to June, 2015 were randomly assigned by a random number table to receive PKP (the PKP Group, n=40) or conservative treatment (the CT Group, n=40). The two groups were compared in improvements in vertebral fracture restoration and symptom relief before and after treatment. Their improvements in vertebral height and Cobb angle of kyphosis before and after treatment were also measured. In addition, their pain relief and physical functions were assessed with the use of Visual analog scales (VAS) pain scores and Oswestry Disability Index (ODI) scores. Results: The postoperative vertebral height restoration (14.1 mm) of the patients in the PKP Group was significantly improved as compared with that before treatment, and the difference was statistically significant (P<0.05); but no significant improvements were found in the CT group; the decrease in Cobb angle was significantly greater in the PKP Group than in the CT group (P<0.05). Improvements in VAS pain scores and ODI scores at various time points postoperatively were also significantly greater in the PKP Group than in the CT group (P<0.05). Conclusion: The PKP treatment could provide immediate pain relief for the patients and takes the advantages of bringing more significant improvements in vertebral fracture restoration, better correction in kyphosis and weight- bearing capacity at an earlier stage. However, although conservative treatment might lead to smaller trauma, it cannot bring complete restoration in compressed vertebral height and in Cobb angle. Also, it was found to have a high incidence of complications. In such cases, the patients' quality of life warrants further improvement.