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体外冲击波联合经皮椎体成形术治疗绝经后女性骨质疏松性胸腰椎压缩骨折的镇痛效果。

The analgesic efficacy of extracorporeal shock wave combined with percutaneous vertebroplasty in the treatment of osteoporotic thoracolumbar compression fractures in postmenopausal women.

机构信息

Department of Spinal Surgery, Affiliated Hospital of Weifang Medical University, Weifang, 261031, China.

Department of Operating Room, Affiliated Hospital of Weifang Medical University, Weifang, China.

出版信息

Biomed Eng Online. 2021 Jun 10;20(1):58. doi: 10.1186/s12938-021-00894-4.

Abstract

BACKGROUND

To explore the analgesic efficacy of extracorporeal shock wave (ESW) combined with percutaneous vertebroplasty (PVP) after reduction in overextension position in the treatment of osteoporotic thoracolumbar compression fractures in postmenopausal women.

METHODS

The data of postmenopausal women with osteoporotic thoracolumbar compression fracture admitted in our department from January 2017 to October 2019 were analyzed retrospectively. They were divided into groups of unipedicular percutaneous kyphoplasty (U-PKP n = 21), bipedicular PKP (B-PKP n = 20), and ESW combined with PVP after reduction in overextension position (EP-PVP n = 18). The improvement of pain and vertebral height in three groups was compared.

RESULTS

Postoperative compression rate and Cobb angle of vertebral fractures in the three groups were all lower than those before surgery, and the differences between pre-operation and post-operation were statistically significant (P < 0.05). The visual analog scale (VAS) and Oswestry dysfunction index (ODI) scores of the three groups decreased significantly after the operation (P < 0.05). The ODI scores of the EP-PVP group in the third months after the operation were significantly improved compared with the other two groups, and the difference was statistically significant (P < 0.05).

CONCLUSIONS

In our small-sample study, all three treatment schemes can treat osteoporotic compression fracture of thoracolumbar vertebrae in postmenopausal women, relieve pain, and improve quality of life. ESW combined with PVP after reduction in overextension position could achieve a good vertebral reduction rate and improve kyphosis, and may reduce the application of analgesic drugs.

摘要

背景

探讨体外冲击波(ESW)联合过伸位复位后经皮椎体成形术(PVP)治疗绝经后女性骨质疏松性胸腰椎压缩骨折的镇痛效果。

方法

回顾性分析 2017 年 1 月至 2019 年 10 月我科收治的绝经后骨质疏松性胸腰椎压缩骨折患者的临床资料,根据治疗方法分为单枚经皮椎体后凸成形术(U-PKP 组,n=21)、双枚经皮椎体后凸成形术(B-PKP 组,n=20)和 ESW 联合过伸位复位后 PVP 组(EP-PVP 组,n=18),比较三组患者疼痛及椎体高度改善情况。

结果

三组患者术后骨折椎体的压缩率及 Cobb 角均低于术前,差异有统计学意义(P<0.05);三组患者术后视觉模拟评分(VAS)和 Oswestry 功能障碍指数(ODI)评分均较术前明显降低,差异有统计学意义(P<0.05);EP-PVP 组术后 3 个月 ODI 评分明显优于另外两组,差异有统计学意义(P<0.05)。

结论

在本小样本研究中,三种治疗方案均可治疗绝经后女性骨质疏松性胸腰椎压缩骨折,缓解疼痛,提高生活质量,ESW 联合过伸位复位后 PVP 能达到较好的椎体复位率,改善后凸畸形,且可能减少镇痛药物的应用。

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