Muijs S P J, Nieuwenhuijse M J, Van Erkel A R, Dijkstra P D S
Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, The Netherlands.
J Bone Joint Surg Br. 2009 Mar;91(3):379-84. doi: 10.1302/0301-620X.91B3.20970.
In a prospective study between August 2002 and August 2005, we studied the quantitative clinical and radiological outcome 36 months after percutaneous vertebroplasty for intractable type-II osteoporotic vertebral compression fractures which had been unresponsive to conservative treatment for at least eight weeks. We also examined the quality of life (QoL). The clinical follow-up involved the use of a pain intensity numerical rating scale (PI-NRS, 0 to 10), the Short-Form 36 (SF-36) QoL questionnaire and an anamnestic questionnaire before and at seven days (PI-NRS only), and one, three, 12 and 36 months post-operatively. A total of 30 consecutive patients received percutaneous vertebroplasty for 62 vertebral compression fractures with a mean time between fracture and treatment of 7.7 months (2.2 to 39). An immediate, significant and lasting reduction in the average and worst back pain was found, represented by a decrease of 3.1 and 2.7 points after seven days and 3.1 and 2.8 points after 36 months, respectively (p < 0.00). Comparison of the pre- and post-vertebroplasty scores on the various SF-36 domains showed an ultimate significant increase in six of eight domains and both summary scores. Asymptomatic leakage of cement was found in 47 of 58 (81%) of treated vertebrae. Two minor complications occurred, an asymptomatic pulmonary cement embolism and a cement spur along the needle track. Percutaneous vertebroplasty in the treatment of chronic vertebral compression fractures results in an immediate, significant and lasting reduction in back pain, and overall improvement in physical and mental health.
在2002年8月至2005年8月的一项前瞻性研究中，我们对至少八周保守治疗无效的顽固性II型骨质疏松性椎体压缩骨折经皮椎体成形术后36个月的临床和放射学定量结果进行了研究。我们还检查了生活质量（QoL）。临床随访包括使用疼痛强度数字评分量表（PI-NRS，0至10）、简短36项健康调查（SF-36）生活质量问卷以及术前、术后七天（仅PI-NRS）、术后1个月、3个月、12个月和36个月的问诊问卷。共有30例连续患者因62处椎体压缩骨折接受了经皮椎体成形术，骨折与治疗之间的平均时间为7.7个月（2.2至39个月）。发现平均和最严重的背痛立即、显著且持续减轻，分别在术后七天下降3.1分和2.7分，术后36个月下降3.1分和2.8分（p < 0.00）。对椎体成形术前和术后SF-36各领域评分的比较显示，八个领域中的六个领域以及两个总结评分最终均有显著提高。在58处接受治疗的椎体中有47处（81%）发现了无症状的骨水泥渗漏。发生了两例轻微并发症，一例无症状的肺骨水泥栓塞和一例沿针道的骨水泥骨突。经皮椎体成形术治疗慢性椎体压缩骨折可立即、显著且持续减轻背痛，并全面改善身心健康。
