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经皮椎体成形术与保守治疗急性症状性骨质疏松性脊柱骨折的功能及影像学结果评估

An evaluation of the functional and radiological results of percutaneous vertebroplasty versus conservative treatment for acute symptomatic osteoporotic spinal fractures.

作者信息

Balkarli Hüseyin, Kilic Mesut, Balkarli Ayşe, Erdogan Murat

机构信息

Akdeniz University, School of Medicine, Department of Orthopaedics and Traumatology, Turkey.

Samsun 19 Mayıs University, School of Medicine, Department of Orthopaedics and Traumatology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey.

出版信息

Injury. 2016 Apr;47(4):865-71. doi: 10.1016/j.injury.2016.01.041. Epub 2016 Feb 8.

Abstract

PURPOSE

This study aimed to compare the results of the two different treatment regimens (percutaneous vertebroplasty (PV) and conservative treatment (CT)) regarding to efficacy, quality of life, functional and radiological results in patients with acute osteoporotic vertebral compression fractures (OVF).

METHODS

The study comprised 83 patients who presented with complaints of OVF associated with osteoporosis and were treated with CT (37) or PV (46). All patients were evaluated according to preoperative and postoperative visual analogue scale (VAS), Oswestry disability index (ODI) and plain radiographs.

RESULTS

All patients in VP group reported a significant decrease in pain at 1st day postoperative. While Pain relief and functional outcomes were significantly better in PV group than CT at 1st and 3rd months according to VAS and ODI scores, there were no statistically significant differences between the groups at 6th months follow-up. The mean preoperative local sagittal Cobb angle (LSCA) and the mean vertebra corpus mid-level height (MVCH) were 42.3° and 14.6 mm in the PV group, while they were measured as 39.8° and 15.7 mm in CT group, respectively. 15.6° decreasing the LSCA and 10.2 mm increasing MVCH were noted in the PV group at the 6th month follow-up. While LSCA increased 19.1° and MVCH decreased 7.6mm in CT group at same time period (p<0.001).

CONCLUSIONS

Compared to the CT group, PV provides a rapid decrease of pain and an early return to daily life activities. Although improvement was observed on the radiological findings following treatment in the PV group, PV may not enhance the quality of life in patients with acute OVF at 6th months follow up.

摘要

目的

本研究旨在比较两种不同治疗方案(经皮椎体成形术(PV)和保守治疗(CT))在急性骨质疏松性椎体压缩骨折(OVF)患者中的疗效、生活质量、功能及影像学结果。

方法

本研究纳入83例因骨质疏松合并OVF前来就诊并接受CT治疗(37例)或PV治疗(46例)的患者。所有患者均依据术前及术后视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)及X线平片进行评估。

结果

VP组所有患者术后第1天疼痛均显著减轻。根据VAS和ODI评分,PV组在术后第1个月和第3个月时疼痛缓解及功能结果显著优于CT组,但在6个月随访时两组间无统计学显著差异。PV组术前局部矢状面Cobb角(LSCA)平均值及椎体中部高度(MVCH)平均值分别为42.3°和14.6mm,而CT组分别为39.8°和15.7mm。PV组在6个月随访时LSCA降低15.6°,MVCH增加10.2mm。同期CT组LSCA增加19.1°,MVCH降低7.6mm(p<0.001)。

结论

与CT组相比,PV能快速减轻疼痛并使患者早日恢复日常生活活动。尽管PV组治疗后影像学表现有所改善,但在6个月随访时PV可能无法提高急性OVF患者的生活质量。

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