Panoramic radiomorphometry and vertebral fractures in Spanish postmenopausal women

Objective

To evaluate the relationship between panoramic radiomorphometric indexes, and the presence of osteoporotic fractures in a Spanish postmenopausal women.

Methods

A sample of 120 women (60 with fragility spine fractures and 60 healthy), aged 55–70 years, with fragility spine fractures, were included in this cross-sectional study that was conducted from 2008 to 2011. All the women were referred to undergo a radiological spine examination, spinal densitometry and a panoramic radiograph for assessing osteoporosis using 3 radiomorphometric indexes: Panoramic Mandibular Index (PMI), Mental Index (MI) and Mandibular Cortical Index (MCI). According to mandibular cortical shape, in MCI, three groups were defined: C3 (osteoporosis), C2 (osteopenia), C1 (health).

Results

Significant differences were found between all the MCI groups due to their composition between fractures and non-fractures. C1 group (healthy) has less fractures women than C2 (Bonferroni p < 0.001), C1 has less fractures than C3 (Bonferroni p < 0.001) and finally, C2 has less fractures than C3 (Bonferroni p < 0.006). PMI and MI values were significantly lower in cases than in controls (U Mann–Whitney p < 0.001).

Conclusions

Panoramic radiomorphometrics mandibular indexes such as MCI, PMI, and MI, may be useful for identifying the population at higher risk for fracture. The relationship between panoramic index and osteoporosis remains unclear and further studies using fragility fracture as a real marker of osteoporosis are warranted to clarify the exact role and effect of one condition on the other and the corresponding clinical implications.     

Interest of biochemical markers of bone turnover for long-term prediction of new vertebral fracture in postmenopausal osteoporotic women

Objective: To analyse the interest of baseline levels and short-term (3-months) changes in serum osteocalcin (BGP), serum bone-specific alkaline phosphatase (BALP) and urinary C-telopeptide of type I collagen/creatinine ratio (U-CTX) to predict 3-years changes in bone mineral density (BMD) and spinal deformity index (SDI) in postmenopausal osteoporotic women. Methods: Data were derived from a cohort of 603 osteoporotic women corresponding to the placebo arm of a 3-years prospective, double-blind study. Results: Baseline values of BALP, BGP and U-CTX were negatively and significantly correlated with baseline spinal BMD. Significant correlations were also observed between the changes in BMD observed after 36 months at the spine and baseline BALP (r=0.20, P=0.0001), BGP (r=0.09, P=0.05) and U-CTX (r=−0.11, P=0.02). At 3 years, 71 women (15.9%) showed an increase in their SDI, corresponding to the occurrence of at least one new vertebral deformity. Baseline values of the four bone turnover markers (BTM) were not significantly related to the occurrence of new vertebral deformities. However, when considering the changes in the BTM observed after 3-months of follow-up, BGP (P=0.003) and U-CTX (P=0.047) were identified as significant predictors of an increase of SDI. The associated odds ratios (95% confidence interval (CI)) were 10.922 (2.218–53.78) for unit changes of log BGP and 1.369 (1.003–1.867) for unit changes of log U-CTX. The relative risk (RR) (IC 95%) of having a new vertebral fracture over 36 months was 0.31 (0.15–0.65) when being in the lowest quartile of 3-months changes in BGP as compared with the highest. Conclusion: We conclude that two sequential measurements of BGP and U-CTX performed at 3-months intervals could be of interest to identify postmenopausal osteoporotic women with the highest risk to present new vertebral deformities.     

Vitamin D insufficiency: A risk factor to vertebral fractures in community-dwelling elderly women

Objective

To determine the risk factors for the presence of moderate/severe vertebral fracture, specifically 25-hydroxyvitamin D (25-OHD).

Study design

Cross-sectional study conducted for 2 years in the city of São Paulo, Brazil including community-dwelling elderly women.

Methods

Bone mineral density (BMD), serum 25-OHD, intact parathyroid hormone (iPTH), calcium and estimated glomerular filtration rate (eGFR) were examined in 226 women without vertebral fractures (NO FRACTURE group) and 189 women with at least one moderate/severe vertebral fracture (FRACTURE group). Vertebral fracture assessment (VFA) was evaluated using both the Genant semiquantitative (SQ) approach and morphometry.

Results

Patients in the NO FRACTURE group had lower age, increased height, higher calcium intake, and higher BMD compared to those patients in the FRACTURE group (p < 0.05). Of interest, serum levels of 25-OHD in the NO FRACTURE group were higher than those observed in the FRACTURE group (51.73 nmol/L vs. 42.31 nmol/L, p < 0.001). Reinforcing this finding, vitamin D insufficiency (25-OHD < 75 nmol/L) was observed less in the NO FRACTURE group (82.3% vs. 93.65%, p = 0.001). After adjustment for significant variables within the patient population (age, height, race, calcium intake, 25-OHD, eGFR and sites BMD), the logistic-regression analyses revealed that age (OR = 1.09, 95% CI 1.04–1.14, p < 0.001) femoral neck BMD (OR = 0.7, 95% CI 0.6–0.82, p < 0.001) and 25-OHD <75 nmol/L (OR = 2.38, 95% CI 1.17–4.8, p = 0.016) remains a significant factor for vertebral fracture.

Conclusion

Vitamin D insufficiency is a contributing factor for moderate/severe vertebral fractures. This result emphasizes the importance of including this modifiable risk factor in the evaluation of elderly women.     

PKP治疗骨质疏松性椎体压缩骨折疗效分析

目的总结经皮椎体后凸成形术(Percutaneous kyphoplasty,PKP)治疗骨质疏松性椎体压缩骨折的临床疗效。方法收集2009年08月~2013年08月泰州市中医院骨科采用PKP治疗的72例(80个椎体)患者资料;采用疼痛视觉模拟评分(Visual analogue scale,VAS)进行手术前后疼痛评估,观察Cobb角变化及并发症情况。结果术后随访1年以上;所有病例疼痛症状均缓解,VAS评分术前(8.0±0.82)分、术后(3.7±0.66)分,差异有统计学意义(0.05);Cobb角术前为(23.49±12.75)°,术后(10.35±5.57)°,差异均有统计学意义(0.05);本组病例手术均获得成功,12例患者出现骨水泥渗漏,8例渗漏到椎体旁,未出现椎体后缘渗漏,均未出现神经症状;相邻椎体骨折2例,伤椎再骨折3例。结论 PKP治疗骨质疏松性椎体压缩骨折可快速有效地缓解患者疼痛、恢复病椎高度,术中术后并发症发生率低。     

EMAS position statement: The management of postmenopausal women with vertebral osteoporotic fracture

Introduction

Osteoporotic vertebral fractures are associated with significant morbidity, excess mortality as well as health and social service expenditure. Additionally, women with a prevalent osteoporotic vertebral fracture have a high risk of experiencing a further one within one year. It is therefore important for the physician to use a diagnostic and therapeutic algorithm for early detection and effective treatment of vertebral fractures.

Aims

The aim of this position statement is to provide and critically appraise evidence on the management of women with a vertebral osteoporotic fracture.

Materials and methods

Literature review and consensus of expert opinion.

Results and conclusions

The management of women with osteoporotic vertebral fractures includes measures to reduce pain providing early mobility, to support the affected spine ensuring fracture healing, as well as starting treatment for osteoporosis itself. Any other underlying pathology should be sought and treated. Early detection and treatment is essential as there is an increased risk of further fractures in patients with vertebral fractures. Treatment will depend on the underlying causes of bone loss, efficacy in any particular situation, cost and patient preference.     

Relation between obesity and bone mineral density and vertebral fractures in Korean postmenopausal women

Purpose

The traditional belief that obesity is protective against osteoporosis has been questioned. Recent epidemiologic studies show that body fat itself may be a risk factor for osteoporosis and bone fractures. Accumulating evidence suggests that metabolic syndrome and the individual components of metabolic syndrome such as hypertension, increased triglycerides, and reduced high-density lipoprotein cholesterol are also risk factors for low bone mineral density. Using a cross sectional study design, we evaluated the associations between obesity or metabolic syndrome and bone mineral density (BMD) or vertebral fracture.

Materials and Methods

A total of 907 postmenopausal healthy female subjects, aged 60-79 years, were recruited from woman hospitals in Seoul, South Korea. BMD, vetebral fracture, bone markers, and body composition including body weight, body mass index (BMI), percentage body fat, and waist circumference were measured.

Results

After adjusting for age, smoking status, alcohol consumption, total calcium intake, and total energy intake, waist circumference was negatively related to BMD of all sites (lumbar BMD p = 0.037, all sites of femur BMD p < 0.001) whereas body weight was still positively related to BMD of all sites (p < 0.001). Percentage body fat and waist circumference were much higher in the fracture group than the non-fracture group (p = 0.0383, 0.082 respectively). Serum glucose levels were postively correlated to lumbar BMD (p = 0.016), femoral neck BMD (p = 0.0335), and femoral trochanter BMD (p = 0.0082). Serum high density lipoprotein cholesterol (HDLC) was positively related to femoral trochanter BMD (p = 0.0366) and was lower in the control group than the fracture group (p = 0.011).

Conclusion

In contrast to the effect favorable body weight on bone mineral density, high percentage body fat and waist circumference are related to low BMD and a vertebral fracture. Some components of metabolic syndrome were related to BMD and a vertebral fracture.     

Vertebral fractures in women aged 50 years and older with clinical risk factors for fractures in primary care

Background

The identification of vertebral fractures (VFs) is important for decisions on fracture prevention. Vertebral fracture assessment (VFA) was shown to be a patient-friendly and valid method for detecting undiagnosed VFs in (Dutch) women. However, this has only been investigated in women seeking care at secondary or tertiary institutions.

Objective

To investigate the prevalence of previously undiagnosed VFs in women in Dutch primary care using VFA.

Study design

A total of 566 Dutch women aged 50 years and older (mean age, 69 years; SD = 8.4) with clinical risk factors (CRFs) for fractures volunteered for dual-energy X-ray absorptiometry (DXA) measurement and VFA. VFs were defined semi-quantitatively using Genant's method.

Results

One CRF was present in each of 130 women, 274 had two, and 162 women had more than two CRFs. In 120 (21%) of the women, previously unknown osteoporosis (T-score ≤ −2.5 SD) was diagnosed, and in 174 (31%), a previously undiagnosed moderate or severe VF was found. No osteoporosis was found in 130 (75%) of the women with a VF. Based on the outcome of DXA, 21% of the women were eligible for treatment, while the combination of DXA and VFA resulted in a total of 250 (44%) women requiring treatment.

Conclusions

The percentage of previously unknown VFs diagnosed by VFA in women aged 50 years and older with one or more CRFs for fractures in primary care is high. When only using BMD measurements, only half the women eligible for treatment would actually receive this. We recommend performing VFA in all women aged 50 years and older who are referred for DXA based on Dutch case finding criteria.     

经椎弓根内固定+椎体成形治疗胸腰椎骨折18例报告

目的:探讨经椎弓根内固定结合椎体成形术治疗胸腰椎骨折的疗效。方法:采用切开复位经椎弓根内固定椎体成形术治疗胸腰椎骨折18例。结果:18例患者术后随访12~18月。椎体前缘高度恢复至正常的94.5%,术后Cobb角丢失不超过1°,椎体前缘高度丢失不超过2mm,未见有内固定失败现象。结论:切开复位经椎弓根内固定椎体成形术能有效治疗胸腰椎骨折。     

Androgen and estrogen dynamics in women with vertebral crush fractures

Using constant infusions of [³h]androgen/[¹⁴c]estrogen we measured metabolic clearance and production rates and aromatization of androgens to estrogens in post-menopausal women with vertebral crush fractures and compared these results to similar measurements in a similar population of postmenopausal women who did not have vertebral crush fractures.

The mean ±SEM values for the metabolic clearance rates of testosterone and estrone, 220±10 and 880±50 1/day per m², were significantly less in the crush fracture group than the respective mean values in the control group, 280±15 and 1110±70 1/day per m². The mean concentration of estradiol was higher in the crush fracture group, 18±2 pg/ml, compared to that in the control group, 13±1 pg/ml.

However, for the crush fracture group the mean blood production rates of both androstenedione, 0.7±0.1 mg/day, and testosterone, 56±9 μg/day, were significantly less than the respective values in the control group, 1.2±0.2 mg/day and 115±15 μg/day. The production rates for estrone and estradiol were not different for the two groups. In addition the mean value for the fraction of adrostenedione converted to testosterone ([]_BB^A.T) was lower in the crush fracture, 0.030±0.002 compared to the control group, 0.041±0.004.

Thus the amount of biologically available androgen is less in the vertebral crush fracture group than in the control group. However, since these measurements represent an isolated point temporally removed from major changes in bone morphology, their exact relationship to the crush fracture and osteoporotic process remains uncertain.     

Bone loss during oestriol therapy in postmenopausal women

In contrast to all other oestrogens examined thus far oestriol hemisuccinate (12 mg/day) did not prevent bone loss in 28 postmenopausal women. The average bone loss, however, was somewhat less than expected from placebo studies, while the bone loss achieved by a group taking 4–6 mg/day was equal to that achieved by previous placebo groups. To be an effective agent for prevention of post-menopausal osteoporosis oestriol would have to be prescribed in daily doses considerably in excess of 12 mg.     

椎体成形术治疗骨质疏松性椎体压缩骨折的研究进展

随着全球老龄化社会的到来,由骨质疏松引起的椎体压缩骨折的发病率逐年升高,由此引起的其他严重并发症可导致患者残疾、死亡,加重社会的负担。尽管保守治疗能够在短期内获得一定的治疗效果,但从长期来看,无法减少患者的疼痛和其他并发症的发生。经皮椎体成形术和球囊后凸成形术已经在临床得到广泛应用并取得了良好的效果。近几年出现的椎体支架、Kiva等新技术也逐渐引起人们的重视。本文回顾近几年最新的手术技术进展,并对其中尚存的问题进行讨论。     

短节段椎弓根钉内固定结合伤椎内植骨术治疗新鲜胸腰椎骨折

目的探讨短节段椎弓根钉内固定结合伤椎内植骨术治疗新鲜胸腰椎骨折的临床应用及疗效.方法采用后路短节段椎弓根钉系统复位固定并经伤椎椎弓根椎体内植骨术治疗新鲜胸腰椎骨折35例,分别于术前、术后及随访时测量伤椎前、后缘高度和 Cobb 角,比较植骨后推体高度的恢复度和 Cobb 角的纠正度.结果本组病例均获随访,平均随访时间12.5个月.平均骨折愈合时间5.4个月.全部随访患者未出现断钉、断棒及椎弓根钉拔出.所有病例术后及随访时椎体高度和 Cobb 角均纠正良好,脊柱椎体排列良好,椎体内植骨融合良好.其中11例1年后,10例1年半后取内固定物,取内固定物半年后拍片未见椎体高度丢失和塌陷.结论后路短节段椎弓根钉内固定结合伤椎内植骨术治疗新鲜胸腰椎骨折治疗能不仅有效恢复伤椎高度,尽早形成伤椎的骨性愈合,增加伤椎前、中柱的支撑力,重建了伤椎前、中柱的稳定性,而且保留伤椎邻近节段的运动单元功能,恢复脊柱的生理功能,有效防止断钉、内固定物松动、椎体前缘高度丢失、Cobb 角变大、继发腰椎不稳、临近节段间盘退变以及椎管狭窄等并发症的发生.     

Vertebral fracture assessment in Moroccan women: Prevalence and risk factors

Introduction

Vertebral fracture assessment (VFA) is a fast, low-radiation technique which produces images that are of sufficient quality to be used to diagnose the presence of vertebral deformity consistent with fracture.

Objective

To study prevalence and risk factors of vertebral fractures using VFA in asymptomatic Moroccan women.

Methods

The study cohort consists of a population of 328 consecutive women aged over 50 (mean age, weight and BMI of 65 ± 6.5 (50–84) years, 72.0 ± 12.8 (42–125) and 29.4 ± 5.0 (17.1–45.8) kg/m², respectively). Lateral VFA images and scans of the lumbar spine and proximal femur were obtained by two technologists using a GE Healthcare Lunar Prodigy densitometer. Vertebral fractures were defined using a combination of Genant semiquantitative (SQ) approach and morphometry.

Results

68% of vertebrae from T4–L4 and 75% from T8–L4 were adequately visualized on VFA. Vertebral fractures (grades 2 or 3) were detected in 25.6% (84/328) of these women. Thirty-two of women with VFA-identified fracture (38.0%) had only a single vertebral fracture, while the other 61.9% had two or more. Fractures were most common in the mid-thoracic spine and at the thoraco-lumbar junction. As would be expected, the prevalence of VFA-detected fractures increased with age and as BMD declined. Stepwise regression analysis showed that presence of vertebral fracture was mainly related to the spine osteoporotic status, age older than 65, history of peripheral fracture and more than six parities.

Conclusion

Vertebral fractures are common in asymptomatic Moroccan women and are related to age, low BMD, history of fracture and multiparity.     

The incidence of new vertebral compression fractures in women after kyphoplasty and factors involved

PURPOSE: To identify the incidence of new vertebral compression fractures in women after kyphoplasty and to analyze influential factors in these patients. MATERIALS AND METHODS: One hundred and eleven consecutive female patients with osteoporotic vertebral compression fractures (VCFs) underwent kyphoplasty at 137 levels. These patients were followed for 15.2 months postoperatively. For the survey of new vertebral compression fractures, medical records and x-rays were reviewed, and telephone interviews were conducted with all patients. RESULTS: During that time 20 (18%) patients developed new VCFs. The rate of occurrence of new VCFs in one year was 15.5% using a Kaplan-Meier curve. Body mass index (BMI), symptom duration and kyphoplasty level were the statistically significant factors between the patient groups both with and without new VCFs after kyphoplasty. In the comparison between the adjacent and remote new VCF groups, the adjacent new VCF group showed a larger amount of polymethyl methacrylate (PMMA) use during kyphoplasty (p<0.05). Before kyphoplasty, 9.9% of the patients had been prescribed medication for osteoporosis, and 93.7% of the patients started or continued medication after kyphoplasty. The development of new VCFs was affected by the number of vertebrae involved in the kyphoplasty. However, the lower incidence rate (15.5%) of new compression fractures might be due to a greater percentage (93.7% in our study) of patients taking anti-osteoporotic medication before and/or after kyphoplasty. CONCLUSION: When kyphoplasty is planned for the management of patients with osteoporotic VCFs, the application of a small amount of PMMA can be considered in order to lower the risk of new fractures in adjacent vertebrae. The postoperative use of anti- osteoporotic medication is recommended for the prevention of new VCFs.     

伤椎内球囊扩张植骨治疗胸腰椎爆裂骨折的应用价值研究

目的探讨后路钉棒复位固定联合经椎弓根伤椎内球囊扩张后植骨手术,在胸腰椎爆裂骨折治疗中的应用价值。方法 31例胸腰段及腰椎爆裂骨折,采用后路椎弓根钉棒复位固定,经伤椎椎弓根置入PKP系统球囊,扩大伤椎内骨质空腔,植入人工骨填充的方法进行治疗,并在手术时间、透视次数、植骨量、出血量、椎体前后缘平均高度、Cobb角、椎管占位等方面,与钉棒复位经椎弓根单纯植骨方法做初步对比。结果31例爆裂骨折复位固定良好,神经功能ASIA评分无一例加重,伤椎内植骨区域填充良好,22例患者术后坚持随访,无一例断钉断棒,骨折愈合良好,伤椎内无空腔形成,取出内固定物后6月复查,无一例伤椎塌陷;在手术时间、透视次数、出血量、椎体前后缘平均高度、Cobb角、椎管占位等方面,与经椎弓根单纯植骨手术无明显差异,但植骨量更加充分,有明显的统计学差异(P0.01)。结论本术式治疗胸腰椎爆裂骨折理论上是一种有效手段,但与传统的简单钉棒复位固定方式比较,是否可以明显减少钉棒取出后伤椎塌陷的发生,还需深入研究及大宗病例随访。     

Quality of life in women with postmenopausal osteoporosis: Correlation between QUALEFFO 41 and SF-36

Objective

To evaluate quality of life (QoL) in women with postmenopausal osteoporosis, correlating the QUALEFFO 41 with the short-form health survey 36 (SF-36) and evaluated some factors that can influenced the QoL of women with osteoporosis.

Methods

A cross-sectional study was conducted in 220 postmenopausal women (ages ranging from 55 to 80 years). Of the total number, 110 women had osteoporosis and 110 women did not have osteoporosis and these women were age-matched (±3 years). Two questionnaires were administered to all subjects for evaluation of QoL: the quality of life questionnaire of the European foundation for Osteoporosis 41 (QUALEFFO 41) and the short-form health survey 36 (SF-36). For data analysis, a significance level of 5% was set (p < 0.05).

Results

Clinical characteristics between the groups were similar, with statistically significant differences only in body mass index (BMI), race, school education, age at menopause and use of hormone therapy (HT) (p < 0.001). Women with osteoporosis had a worse QoL both in the QUALEFFO 41 and in the SF-36, in all domains studied. Data was adjusted for BMI, race, school education and use of HT (p < 0.001). There was a significant correlation between all domains in the QUALEFFO 41 questionnaire and their corresponding domains in the SF-36 (p < 0.001). The only factors related to worse QoL were BMI > 25 and sedentary lifestyle. In contrast, paid work was associated with a better QoL (CI = 95%).

Conclusion

Women with osteoporosis had an impaired QoL, especially relating to the physical, psychological and social aspects. The factors associated with QoL were obesity, sedentary lifestyle and paid work.     

椎旁肌间隙与传统入路置钉技术在胸腰椎骨折中的效果比较研究

目的　比较椎旁肌间隙与传统入路置钉技术在胸腰椎骨折中的应用效果。 方法　从2011年4月到2012年12月,收治的142例胸腰椎骨折患者以数字法随机分成观察组（71例）和对照组（71例）。对两组患者均行后侧入路置钉手术。观察组采用椎旁肌间隙入路置钉技术;对照组采用传统入路置钉技术。对比两组的手术时间,术中出血量和引流量,对比两组患者术后3d、1个月、6个月的VAS评分以及两组术后的椎体高度矫正率对比。 结果　观察组手术时间为(89.52±12.15)min,出血量为(139.61±36.25)ml,引流量为(59.62±9.15)ml,显著低于对照组的(138.57±9.98) min,(413.54±29.83)ml,(373.14±11.83)ml。差异均有统计学意义（均P＜0.05）。术后3 d、1月、半年观察组VAS评分分别为（5.01±0.98）、（2.33±1.13）、（0.71±0.69）,显著低于对照组的（5.55±1.15）、（3.09±1.25）和（1.74±0.85）。差异均有统计学意义（P<0.05）。观察组的矫正率达到了（96.80±2.51）%,对照组的(95.68±2.89)%。差异无统计学意义（P>0.05）。 结论　椎旁肌间隙入路置钉技术在胸腰椎骨折的临床应用上具有手术时间短,安全矫正率与传统入路无差异的特点,安全性好,患者恢复情况好,值得临床的推广。     

高粘度与低粘度骨水泥PVP治疗骨质疏松性椎体压缩骨折疗效及安全性分析

目的对比较经皮椎体成形术(PVP)中使用高粘度骨水泥与低粘度骨水泥治疗骨质疏松性椎体压缩骨折(OVCF)的临床疗效和安全性。方法将68例OVCF行PVP治疗的患者分为高粘度组与低粘度组,分别采用高粘度骨水泥与低粘度骨水泥修复,比较两组患者疼痛缓解(VAS)、脊柱功能改善情况(ODI)、骨水泥渗漏发生率、术后骨水泥肺栓塞发生率及术后邻近椎体骨折发生率情况。结果末次随访,两组VAS、ODI评分均较术前改善,但高粘度组较低粘度组改善更加明显,差异均有统计学意义(0.01)。高粘度组骨水泥渗漏发生为2.9%,明显低于低粘度组(20.6%),差异有统计学意义(x~2=5.100,0.05);高粘度组术后骨水泥肺栓塞发生率为0,明显低于低粘度组(11.8%),差异有统计学意义(x~2=4.250,0.05);高粘度组术后邻近椎体骨折发生率为0,明显低于低粘度组术后邻近椎体骨折发生率(14.7%),差异有统计学意义(x~2=5.397,0.05)。结论经皮椎体成形术中使用高粘度骨水泥疗效显著,术后并发症少。     

高粘稠度骨水泥PVP术和PKP术治疗老年椎体压缩性骨折的临床效果对比

目的对比高粘稠度骨水泥PVP术和PKP术治疗老年椎体压缩性骨折的临床效果。方法回顾性分析2014年1月至2016年4月于我院治疗的椎体压缩性骨折的老年患者共102例,采用高粘稠度骨水泥PVP术47例(PVP组),高粘稠度骨水泥PKP术55例(PKP组),对比两组患者骨水泥用量和渗漏率,治疗24 h及术后6个月后脊柱后凸Cobb's角、椎体高度、腰背部VAS评分、ODI评分和JOA评分。结果两组患者的手术椎体数量比较差异无统计学意义(0.05),PKP组患者中单个椎体骨水泥使用量显著高于PVP组(0.05),两组患者治疗后1、3、6月的JOA得分比较差异无统计学意义(0.05),治疗前、治疗后24 h、6个月的脊柱后凸Cobb's角、腰背部VAS评分、ODI评分和椎体高度比较差异均无统计学意义(0.05)。结论高粘度骨水泥PVP和PKP治疗老年椎体压缩性骨折,PVP使用骨水泥量少于PKP,骨水泥渗漏率相当,均可显著改善疼痛及腰部的功能。