FUNCTIONAL OUTCOMES AND TREATMENT EFFICACY OF CONSERVATIVE, PERCUTANEOUS VERTEBROPLASTY, AND SPINAL RECONSTRUCTION IN OSTEOPOROTIC VERTEBRAL COMPRESSION FRACTURES: A COMPARATIVE STUDY
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Keywords
Osteoporotic vertebral compression fractures, percutaneous vertebroplasty, spinal reconstruction, conservative management, functional outcomes, pain relief, Oswestry Disability Index, Visual Analog Scale, SF-36
Abstract
Introduction: Osteoporotic vertebral compression fractures (OVCF) are a common and debilitating condition that causes significant pain, functional limitations, and reduced quality of life, particularly among the elderly. With several treatment options available, including conservative management, percutaneous vertebroplasty (PVP), and spinal reconstruction, there is a need to compare the clinical and functional outcomes of these modalities to optimize treatment strategies for OVCF patients.
Methodology: This prospective study included 96 patients with symptomatic OVCF, who were treated between June 2014 and December 2016. Patients were divided into three groups: 30 treated with percutaneous vertebroplasty, 32 with decompression and spinal transpedicular screw reconstruction, and 34 receiving conservative management. Pre-operative evaluations included Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and SF-36 scores, along with imaging studies such as X-rays, MRI, and dual-energy X-ray absorptiometry (DEXA). Patients were assessed at six weeks, three months, six months, and one year follow-up.
Results: The results showed significant improvement in pain, disability, and quality of life across all groups. The vertebroplasty group demonstrated the greatest improvement, with a reduction in ODI from 67.97±5.96 to 17.20±2.20 (p<0.001) and VAS scores from 7.6 to 0.43 (p<0.001). The spinal reconstruction group also showed significant improvements in ODI and VAS scores, while the conservative treatment group exhibited moderate improvements. Complications such as dural tear, cement leakage, and persistent pain were observed but managed successfully without significant long-term neurological deficits.
Conclusion: The study concludes that both vertebroplasty and spinal reconstruction are highly effective in improving pain, functional outcomes, and quality of life in OVCF patients, with minimal complications when performed in appropriate candidates. Conservative management provides moderate improvement, but surgical interventions offer superior outcomes in terms of pain relief and functional recovery. Treatment selection should be individualized, with careful consideration of the patient's condition, fracture severity, and potential for recovery.
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Dr.Vijay Kamble
Orthopedic Surgeon, Meenakshi Hospital, Near J K Thackrey Hospital, Dhule
Dr Sandeep Reddy
Orthopedic and Knee surgeon, Sancheti Institute of Orthopedics and rehabilitation,Pune
Dr. Shailesh Hadgaonkar
Orthopedic and Spine surgeon, Sancheti Institute of Orthopedics and rehabilitation,Pune
Dr.Ashok Shyam
Orthopedic and Research Head, Sancheti Institute of Orthopedics and rehabilitation,Pune
Dr.Parag Sancheti
Orthopedic and Research Head, Sancheti Institute of Orthopedics and rehabilitation,Pune