Kaliya-Perumal Arun-Kumar, Lin Tung-Yi
Department of Orthopaedic Surgery, Melmaruvathur Adhiparasakthi Institute of Medical Sciences and Research, Melmaruvathur, Tamil Nadu, India.
Department of Orthopaedic Surgery, Spine Division, Bone and Joint Research Center, Chang Gung Memorial Hospital (Keelung Branch) and Chang Gung University College of Medicine, Taoyuan, Taiwan.
J Clin Orthop Trauma. 2018 Mar;9(Suppl 1):S140-S144. doi: 10.1016/j.jcot.2017.06.006. Epub 2017 Jun 8.
Elderly patients sustaining a trivial fall may develop vertebral compression fractures if they are predisposed to any factor that leads to decreased bone mineral density. Such patients suffer with severe pain and disability during the early healing stages. Percutaneous Vertebroplasty is mainly done to provide immediate pain relief and also believed to offer stability to the compressed vertebra by preventing further collapse.
Selected patients [n = 20; Age = 57.9 ± 7.9 years] with osteoporotic vertebral compression fracture of a single dorsolumbar vertebra were treated with percutaneous vertebroplasty after 2-3 weeks of conservative trail. Their Pain score was noted using numeric rating scale (NRS) before and after the procedure. Functional outcomes were analysed using Roland Morris Disability Questionnaire (RMDQ) score.
NRS pain score before procedure was 8.3 ± 0.6. RMDQ score before procedure was 21.6 ± 0.5. Third post procedural day NRS pain score was 4.7 ± 1.2 (p < 0.0001), denoting significant decrease in pain. Functional outcome analysis using RMDQ score showed an average of 87 ± 6.1 percent improvement (p < 0.0001), by 6 weeks following procedure. Considering pre-injury status all patients were in their best possible functional state by 6 weeks.
Percutaneous Vertebroplasty serves its purpose adequately and economically. Under controlled circumstances, it offers immediate pain relief and stability, leading to early recovery in selective patients. Yet, underlying poor bone mineral density status needs to be treated.
Observational Case Series (Level 4).
轻微跌倒的老年患者如果存在导致骨密度降低的任何因素，可能会发生椎体压缩骨折。这类患者在早期愈合阶段会遭受剧痛和功能障碍。经皮椎体成形术主要用于立即缓解疼痛，并且据信通过防止进一步塌陷可为压缩椎体提供稳定性。
选择20例（年龄57.9±7.9岁）单节段胸腰椎骨质疏松性椎体压缩骨折患者，在进行2 - 3周保守治疗后接受经皮椎体成形术。在手术前后使用数字评分量表（NRS）记录他们的疼痛评分。使用罗兰·莫里斯功能障碍问卷（RMDQ）评分分析功能结局。
术前NRS疼痛评分为8.3±0.6。术前RMDQ评分为21.6±0.5。术后第三天NRS疼痛评分为4.7±1.2（p<0.0001），表明疼痛显著减轻。使用RMDQ评分进行的功能结局分析显示，术后6周平均改善87±6.1%（p<0.0001）。考虑到受伤前的状态，所有患者在6周时都处于最佳功能状态。
经皮椎体成形术能充分且经济地实现其目的。在可控的情况下，它能立即缓解疼痛并提供稳定性，使部分患者早期康复。然而，潜在的骨密度低下状况仍需治疗。
观察性病例系列（4级）。
