Wright State University School of Medicine, Dayton, OH, USA.
J Vasc Interv Radiol. 2012 Nov;23(11):1416-22. doi: 10.1016/j.jvir.2012.08.003. Epub 2012 Sep 26.
To evaluate whether the age of a fracture is a variable that can identify patients for whom vertebroplasty would be most beneficial.
Data from 256 patients with painful osteoporotic vertebral compression fractures (VCFs) who underwent vertebroplasty were examined to assess the effect of fracture age on outcomes. Patients ranged in age from 34-76 years, and the age of fractures ranged from 6 weeks or less (n = 117) to more than 52 weeks (n = 3). Most patients had a fracture age of 12 weeks or less (n = 207), with only 17% having a fracture age greater than 12 weeks. The duration of back pain was used as a surrogate for fracture age and was confirmed by edema on magnetic resonance (MR) imaging, abnormal bone scans, and the presence of central pain over the spinous process The primary outcome was pain reduction as determined by the change in the visual analog scale (VAS) pain score from baseline and at 1, 3, 6, and 24 months after vertebroplasty.
A fracture age of 12 weeks or less versus greater than 12 weeks did not affect outcomes, with patients in both groups achieving equivalent benefit after vertebroplasty. Patients with a fracture age of 6 weeks or less had a slightly improved benefit at 3 months after vertebroplasty compared with those having a fracture age of greater than 6 weeks, but the benefit beyond 3 months was the same.
Results of the study showed that the age of a fracture does not independently affect the outcomes of vertebroplasty.
评估骨折年龄是否为一个可识别哪些患者最适合行椎体成形术的变量。
对 256 例因骨质疏松性椎体压缩性骨折(VCF)而行椎体成形术的疼痛患者的数据进行了检查,以评估骨折年龄对疗效的影响。患者年龄 34-76 岁,骨折年龄 6 周或更短(n=117)至超过 52 周(n=3)。大多数患者的骨折年龄为 12 周或更短(n=207),只有 17%的患者骨折年龄大于 12 周。腰背疼痛持续时间作为骨折年龄的替代指标,并通过磁共振成像(MR)上的水肿、异常骨扫描和棘突上中央疼痛的存在得到证实。主要结局是通过视觉模拟量表(VAS)疼痛评分从基线和椎体成形术后 1、3、6 和 24 个月的变化来确定疼痛缓解。
12 周或更短的骨折年龄与大于 12 周的骨折年龄没有影响疗效,两组患者在椎体成形术后均获得同等获益。骨折年龄 6 周或更短的患者在椎体成形术后 3 个月时的获益略优于骨折年龄大于 6 周的患者,但 3 个月后的获益相同。
研究结果表明,骨折年龄并不能独立影响椎体成形术的疗效。