Analysis  of  Percutaneous Kyphoplasty under Different Types of Anesthesia for the Treatment of Multiple Osteoporotic Vertebral Fractures

Abstract

Background Surgeons believe that the advantage of PKP under local anesthesia for the treatment of OVF in preventing interference with the general situation of elderly patients with multiple organ dysfunction. Surgeons can directly assess whether a spinal cord nerve injury occurs while the patient is awake. However, when patients with m-OVFs receive local anesthesia, fluoroscopy time often has to be increased,the operative time has to be extended, or the operation has to be terminated because of body posture-related discomfort, the toxic reaction of bone cement, and abrupt fluctuation of vital signs. No relevant study has thus far been conducted on the choice of the type of anesthesia to administer to patients undergoing PKP for m-OVFs.This study aimed to determine which of the two types of anesthesia is more suitable for PKP for m-OVFs. Methods A retrospective study was conducted for 159 patients who underwent PKP for m-OVFs from January 2016 to January 2020; 81 patients underwent PKP under general anesthesia(Group G), and 78 patients underwent PKP under local anesthesia(Group L). Clinical and adverse events were compared between the two groups. Results No difference in baseline information was found between the two groups. The intraoperative mean arterial pressure, average heart rate, average fluoroscopy times of each vertebral body, and operative time were less in Group G than in Group L. The VAS score was significantly lower than that before operation. The AVH, MVH, and the KA were significantly improved in both groups postoperation. The improvement in VAS score, AVH, MVH, and KA in Group G were higher than those in Group L. No significant difference in the incidence of complications was observed between the two groups. Conclusion PKP under either general anesthesia or local anesthesia was reliable. Compared with PKP under local anesthesia, that under general anesthesia could more reliably maintain the stability of vital signs, alleviate preoperative pain in patients, and attain a better orthopedic effect. Moreover, the latter does not increase the complications of patients with m-OVFs. However, the high medical expense of PKP under general anesthesia is a factor to consider when choosing the type of anesthesia.