Chinese Journal of Tissue Engineering Research ›› 2020, Vol. 24 ›› Issue (20): 3168-3173.doi: 10.3969/j.issn.2095-4344.2609

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Facet joint injection versus percutaneous kyphoplasty for mild vertebral fragility fractures: rapid analgesia and restoration of spinal stability

Luo Wei1, Chen Jianping2, Sun Qianqian1, Chen Chen3, Li Hang2, Ma Chenglong1, Su Rui1, Feng Xiaoyue1, Sun Yurui1   

  1. 1Department of Anesthesia, Shanxi Medical University, Taiyuan 030001, Shanxi Province, China; 2Department of Pain Management, 3Department of Orthopedics, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Taiyuan 030032, Shanxi Province, China
  • Received:2019-07-25 Revised:2019-08-01 Accepted:2019-10-09 Online:2020-07-18 Published:2020-04-13
  • Contact: Chen Jianping, MD, Chief physician, Department of Pain Management, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Taiyuan 030032, Shanxi Province, China
  • About author:Luo Wei, Master candidate, Department of Anesthesia, Shanxi Medical University, Taiyuan 030001, Shanxi Province, China

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Abstract:

BACKGROUND: Percutaneous kyphoplasty (PKP) for the treatment of osteoporotic compression fractures has been widely recognized in clinical practice, but clinicians are still impelled to seek for new treatment regimens due to complications such as bone cement leakage and adjacent vertebral re-fracture.

OBJECTIVE: To compare the therapeutic efficacy of facet joint injection (FJI) and PKP in the treatment of mild vertebral fragility fractures.

METHODS: Forty-six patients with mild vertebral fragility fractures (osteoporotic fractures) were divided into FJI group and PKP group according to the treatment regimens. The two groups of patients were treated with FJI and PKP separately based on standardized anti-osteoporosis treatment. The data of each group were recorded before and 1 week, 1, 3, 6, and 12 months after treatment. The analgesic efficacy was evaluated by visual analogue scale (VAS) and Oswestry disability index (ODI). Spine stability was evaluated by anterior vertebral height, kyphotic angle and lumbar spine density and the incidence of re-fracture were compared. The study protocol was implemented in line with the ethic requirements of Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences in China. Informed consent was obtained from each patient.

RESULTS AND CONCLUSION: Intragroup comparison: VAS and ODI scores of patients in both groups were significantly decreased in each period after treatment compared with the baseline (P < 0.05), and vertebral bone density was significantly increased at the 12th month after treatment (P < 0.05). The anterior vertebral height and kyphosis angle of the PKP group were better than the baseline (P < 0.05). Intergroup comparison: At the 1st week and 1st month after treatment, the VAS and ODI scores of the FJI group were significantly higher than those of the PKP group (P < 0.05), while at the 3rd, 6th, and 12th month, there was no significant difference between the two groups (P > 0.05). After treatment, the anterior vertebral body height and kyphosis angle in the PKP group were better than those in the FJI group (P < 0.05), and there was no significant difference in the incidence of re-fracture (P > 0.05). Standardized anti-osteoporosis treatment with either FJI or PKP can provide effective analgesia for patients with mild vertebral fragility fracture, and PKP has certain advantages in rapid analgesia and recovery of spinal stability.

Key words: facet joint injection, percutaneous kyphoplasty, vertebral fragility fracture, visual analogue scale, Oswestry disability index

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