Do Huy M, Kim Brian S, Marcellus Mary L, Curtis Lisa, Marks Michael P
Department of Radiology, Stanford University Medical Center, Stanford, CA 94305-5105, USA.
AJNR Am J Neuroradiol. 2005 Aug;26(7):1623-8.
Previous studies have retrospectively reported the positive effects of percutaneous vertebroplasty. The purpose of our study was to evaluate prospectively the effects of vertebroplasty on mobility, analgesic use, pain, and SF-36 (short-form 36-item) scales for patients with painful vertebral compression fractures that are refractory to medical therapy.
We prospectively followed 167 patients who received 207 vertebroplasty treatment sessions for stabilization of 264 symptomatic vertebral compression fractures between August 1999 and January 2003. The average age of patients was 74.6 years (SD = 12.2 years), and 76% were women. Pre- and postprocedural measurements of pain, mobility, analgesic use, and SF-36 scales were compared at 1 month after the procedure and between 6 months and 3 years after the procedure with the SF-36 scales.
Respective pre- and post-treatment pain scores were 8.71 (SE = 0.1) and 2.77 (SE = 0.18; P < .00001). Respective pre- and post-treatment analgesic use scores were 2.93 (SE = 0.9) and 1.64 (SE = 0.09; P < .00001). Respective pre- and post-treatment activity levels were 2.66 (SE = 0.1) and 1.64 (SE = 0.11; P < .00001). There was a statistically significant improvement on nine of 10 SF-36 scales (P < .001) after 1 month and on eight of 10 SF-36 scales (P < .02) at long-term follow-up.
Percutaneous vertebroplasty offers statistically significant benefits in decreasing pain, decreasing use of analgesics, and increasing mobility in appropriately selected patients. Percutaneous vertebroplasty also offers a statistically significant benefit in most SF-36 scales at both short- and long-term follow-up.
既往研究已回顾性报道了经皮椎体成形术的积极效果。本研究的目的是前瞻性评估椎体成形术对药物治疗无效的疼痛性椎体压缩骨折患者的活动能力、镇痛药物使用、疼痛及SF-36（简明健康状况调查量表，36条目版）评分的影响。
我们前瞻性随访了167例患者，这些患者在1999年8月至2003年1月期间接受了207次椎体成形术治疗，以稳定264处有症状的椎体压缩骨折。患者的平均年龄为74.6岁（标准差=12.2岁），76%为女性。在术后1个月以及术后6个月至3年时，比较术前和术后疼痛、活动能力、镇痛药物使用及SF-36评分的测量结果。
治疗前和治疗后的疼痛评分分别为8.71（标准误=0.1）和2.77（标准误=0.18；P<0.00001）。治疗前和治疗后的镇痛药物使用评分分别为2.93（标准误=0.9）和1.64（标准误=0.09；P<0.00001）。治疗前和治疗后的活动水平分别为2.66（标准误=0.1）和1.64（标准误=0.11；P<0.00001）。术后1个月时，10项SF-36评分中有9项有统计学显著改善（P<0.001），长期随访时10项中有8项有统计学显著改善（P<0.02）。
经皮椎体成形术在适当选择的患者中，在减轻疼痛、减少镇痛药物使用及提高活动能力方面有统计学显著益处。在短期和长期随访中，经皮椎体成形术在大多数SF-36评分方面也有统计学显著益处。
