Chen Xing, Wan Dun, Xiong Xiao-Ming, Shi Hua-Gang, Deng Xuan-Geng, Gu Tao, Song Si-Mao, Hou Wei, Li Qing-Long
Sichuan Orthopedic Hospital, Chengdu 610041, Sichuan, China.
Zhongguo Gu Shang. 2020 Dec 25;33(12):1179-83. doi: 10.12200/j.issn.1003-0034.2020.12.018.
To study effects of postoperative regular training of core muscle strength guided by the concept of enhanced recovery after surgery (ERAS) on the rehabilitation of elderly patients with osteoporotic lumbar vertebral compression fracture after vertebroplasty (PVP) and kyphoplasty(PKP).
Ninety-four elderly patients with osteoporotic lumbar compression fractures who underwent PKP or PVP from January 2016 to January 2018 and met inclusion criteria were divided into observation group and control group. All the patients were treated with routine anti osteoporosis therapy after operation. There were 47 patients in the observationgroup, including 18 males and 29 females, with an average age of (62.62±3.21) years old;in the control group, there were 47 cases, including 17 males and 30 females, with an average age of (62.38±2.84) years old. The patients in the control group were trained by traditional way, and the patients in observation group were instructed to conduct regular training of core muscle strength according to ERAS concept. The patients were followed up for 1, 3 and 6 months after operation. Patients' conditions were quantitatively evaluated according to Barthel scale, JOA low back pain score and Oswestry Disability Index, and the differences in treatment effects between two groups were statistically analyzed and compared.
All the patients were followed up, and the Barthel scale, JOA low back pain score and Oswestry Disability Index score of the observation group were all better than those of the control group on the 1st and the 3rd months after surgery(< 0.05). The Oswestry Disability Index score of the observation group on the 6th month after surgery were superior to those of the control group (<0.05). However, there was no significantly difference in JOA low back pain score and Barthel scale between two groups at 6 months after surgery (>0.05). The comparison of Barthel scale, JOA low back pain score and Oswestry Disability Index before and after the operation of 1, 3 and 6 months between the two groups were significantly improved (<0.05).
Early regular core strength training has a positive effect on early functional recovery and improvement of life ability after PKP or PVP for elderly patients with osteoporotic lumbar compression fractures, which is in line with the concept of accelerated rehabilitation surgery.
探讨以加速康复外科（ERAS）理念指导的术后核心肌群力量定期训练对老年骨质疏松性腰椎压缩骨折椎体成形术（PVP）和后凸成形术（PKP）患者康复的影响。
选取2016年1月至2018年1月期间行PKP或PVP且符合纳入标准的94例老年骨质疏松性腰椎压缩骨折患者，分为观察组和对照组。所有患者术后均接受常规抗骨质疏松治疗。观察组47例，男18例，女29例，平均年龄（62.62±3.21）岁；对照组47例，男17例，女30例，平均年龄（62.38±2.84）岁。对照组采用传统方式训练，观察组按照ERAS理念指导进行核心肌群力量定期训练。术后对患者进行1、3、6个月随访。依据Barthel指数、JOA腰痛评分及Oswestry功能障碍指数对患者情况进行量化评估，对两组治疗效果差异进行统计学分析比较。
所有患者均获随访，术后1个月及3个月时，观察组Barthel指数、JOA腰痛评分及Oswestry功能障碍指数评分均优于对照组（<0.05）。术后6个月时，观察组Oswestry功能障碍指数评分优于对照组（<0.05），但术后6个月时两组JOA腰痛评分及Barthel指数比较差异无统计学意义（>0.05）。两组术后1、3、6个月时Barthel指数、JOA腰痛评分及Oswestry功能障碍指数术前术后比较均显著改善（<0.05）。
早期定期进行核心肌群力量训练对老年骨质疏松性腰椎压缩骨折患者PKP或PVP术后早期功能恢复及生活能力改善具有积极作用，符合加速康复外科理念。
