Abstract:Objective To investigate the application effect of modified hollow puncture needle in percutaneous vertebroplasty for elderly fragility lumbar vertebral compression fractures.Methods The clinical data of 86 elderly patients with osteoporotic vertebral compression fractures (OVCF) admitted to our hospital from January 2022 to January 2024 were retrospectively collected. According to different treatment methods, the patients were divided into groups. The control group (n = 44) was treated with percutaneous vertebroplasty (PVP), while the observation group (n = 42) received combined application of a puncture needle based on the control group. The perioperative indicators (operation time, intraoperative blood loss, time to ambulation, and hospital stay) were compared between the two groups. Serum stress indicators [adrenocorticotropic hormone (ACTH) and cortisol (Cor) ] levels were measured preoperatively, as well as on postoperative day 1 and postoperative day 7. Patients were followed up for 6 months. The Japanese Orthopaedic Association (JOA) scores, the Oswestry Disability Index (ODI), and the Activities of Daily Living (ADL) scale were used to compare lumbar spine function and mobility between the two groups at preoperative and 6-month postoperative time points. The incidence of complications was also statistically analyzed.Results Comparison of operation time, intraoperative blood loss, postoperative ambulation time and length of hospital stay between the observation group and the control group showed statistically significant differences by t-test (P 0.05); the observation group had lower values in operation time, intraoperative blood loss, postoperative ambulation time and length of hospital stay than the control group. Comparison of adrenocorticotropic hormone (ACTH) and cortisol (Cor) levels between the two groups before surgery, 1 day after surgery and 7 days after surgery was analyzed using repeated-measures analysis of variance. The results were as follows: (1) There were statistically significant differences in ACTH and Cor levels at different time points (F = 298.903, P = 0.000; F = 109.369, P = 0.000). (2) There were statistically significant differences in ACTH and Cor levels between the observation group and the control group (F = 67.511, P = 0.000; F = 107.785, P = 0.000), with lower levels in the observation group. (3) There were statistically significant differences in the changing trends of ACTH and Cor levels between the two groups (F = 56.535, P = 0.000; F = 51.028, P = 0.000). At 6 months postoperatively, the JOA score, ODI score and ADL score were compared between the two groups, and the differences were statistically significant by t-test (P 0.05). The observation group had higher JOA and ADL scores and lower ODI score than the control group. Within each group, the JOA score and ADL score at 6 months postoperatively were significantly higher than those before surgery (P 0.05), while the ODI score was significantly lower (P 0.05). In the control group, there were 6 cases of cement leakage, 1 case of nerve injury and 2 cases of hematoma. In the observation group, there was 1 case of cement leakage and 1 case of hematoma, with no nerve injury.The difference in the overall complication rate between the observation group and the control group was statistically significant by chi-square test (P 0.05); the overall complication rate in the observation group was lower than that in the control group.Conclusion The application of puncture needle in percutaneous vertebroplasty for elderly patients with brittle lumbar vertebral compression fractures can shorten postoperative recovery time, improve lumbar function and daily living ability, and reduce the risk of complications.
