MANAGEMENT OF OSTEOPOROTIC VERTEBRAL COMPRESSION FRACTURES: SURGERY VS. CONSERVATIVE TREATMENT.

Abstract

Background

Osteoporotic vertebral compression fractures (OVCFs) affect significant numbers of the elderly population and results in pain, disability and decreased quality of life. It seems clear that management options, whether surgical or conservative, need to be optimized to change the natural history of the disease, reduce risk, and decrease the incidence of devastating complications.

Objectives

our study aims at comparing surgical management that encompasses both vertebroplasty and kyphoplasty with conservative management to establish their efficiency in managing pain, mobility and quality of life amongst the patients.

Study Design : A Cross Sectional study.

Durtion and place and study. Department of orthopedic HMC Peshawar from July 2021 to  Dec 2021

Methods

The current research is a cross-sectional, descriptive survey involving one hundred and fifty patients diagnosed with OVCFs. Patients were divided into two groups: 40 patients who had vertebral option fracture and 40 patients with pathological fracture received surgical management in the form of vertebroplasty or kyphoplasty while 70 patients were managed conservatively using analgesia, braces, and physical therapies. Data on patients’ outcomes was gathered with the help of pain intensity scores, mobility rates and post-operative complications. All statistical analysis was done using statistical package for social sciences (SPSS 24.0), in order to establish the standard deviations and p-values.

Results

Surgical treatment significantly improved pain scores (VAS: 2.3 ± 0.8) as compared to conservative treatment VAS 4.1 ± 1.2) p < 0.01). Mobility indices were better in the surgical group (Mobility Score: 7.Far-progressive group had a higher Mobility score, 8 ± 1.1 compared with the conservative group, 6.4 ± 1.3 (p = 0.02). Major adverse events were not observed in both groups, but complication rates did not differ; 35% in either procedure group.

Conclusion

Self-report of pain and function suggests that surgical management for OVCFs offer better pain relief and functional outcome than conservative treatments; should therefore be preferred in patients with surgically amenable conditions. But patient-specific attributes and risk claims/criteria must remain the most decisive.