Lin Yu, Liu Wen-Ge, Wang Zhen-Yu
Department of Orthopaedics, Union Hospital Affiliated to Fujian Medical University, Fuzhou 350001, Fujian, China.
Zhongguo Gu Shang. 2022 May 25;35(5):418-22. doi: 10.12200/j.issn.1003-0034.2022.05.003.
To analyze the efficacy of percutaneous vertebroplasty for osteoporotic vertebral compression fractures with spinal origin abdominal pain as the main symptom.
A retrospective analysis was performed on 37 patients with osteoporotic vertebral compression fractures treated from January 2015 to January 2021, all of whom had spin-derived abdominal pain as the main symptom, and were divided into surgery group(21 cases) and conservative group (16 cases) according to different treatment methods. Patients in the surgery group were treated with percutaneous vertebroplasty, including 7 males and 14 females, with an average age of (75.95±6.84) years old and an average course of disease of (5.26±3.79) days. The conservative group received non-surgical treatment, including 5 males and 11 females, with an average age of (75.50±8.07) years old and an average course of disease of (4.28±3.42) days. Two groups of patients with preoperative mainly characterized by abdominal pain, abdominal distension and constipation, have no obvious chest waist back pain symptoms, the thoracolumbar MRI diagnosed as fresh osteoporotic vertebral compression fractures, record its postoperative abdominal pain visual analogue scale (VAS), medical outcomes study short form-36 (SF-36) score, defecation interval after treatment, etc.
Thirty-seven patients were followed up for (14.90±14.11) months in surgery group and( 21.42±17.53) months in conservative group. Compared with before treatment, the VAS of surgery group at each time period after treatment, VAS of conservative group at 1 month after treatment and SF-36 score between two groups at 3 months after treatment were all improved(<0.05), while VAS of conservative group at 3 days after treatment showed no statistically significant difference(>0.05). Compared between two groups, there were no significant differences in VAS and SF-36 scores at 1 day before treatment(>0.05), but VAS at 3 days after treatment in surgery group, life vitality and social function score at 3 months after treatment, and defecation time after treatment in surgery group were better than those in conservative group(<0.05). There were no significant differences in other indexes(>0.05). The incision healing of patients in surgery group was good, and no serious complications occurred in both groups.
Percutaneous vertebroplasty is an effective method for the treatment of osteoporotic vertebral compression fractures with spinal origin abdominal pain as the main symptom. Compared with conservative treatment, percutaneous vertebroplasty has more advantages in early relief of abdominal pain and constipation, recovery of vitality and social function.
分析经皮椎体成形术治疗以脊柱源性腹痛为主要症状的骨质疏松性椎体压缩骨折的疗效。
回顾性分析2015年1月至2021年1月收治的37例以脊柱源性腹痛为主要症状的骨质疏松性椎体压缩骨折患者,根据治疗方法不同分为手术组(21例)和保守组(16例)。手术组患者采用经皮椎体成形术治疗,其中男性7例,女性14例,平均年龄(75.95±6.84)岁,平均病程(5.26±3.79)天。保守组接受非手术治疗,其中男性5例,女性11例,平均年龄(75.50±8.07)岁,平均病程(4.28±3.42)天。两组患者术前均以腹痛、腹胀、便秘为主,无明显胸腰背部疼痛症状,胸腰椎MRI诊断为新鲜骨质疏松性椎体压缩骨折,记录其术后腹痛视觉模拟评分(VAS)、医学结局研究简表36(SF-36)评分、治疗后排便间隔时间等。
手术组37例患者随访(14.90±14.11)个月,保守组随访(21.42±17.53)个月。与治疗前比较,手术组治疗后各时间段VAS、保守组治疗后1个月VAS及两组治疗后3个月SF-36评分均改善(<0.05),而保守组治疗后3天VAS差异无统计学意义(>0.05)。两组间治疗前1天VAS、SF-36评分差异无统计学意义(>0.05),但手术组治疗后3天VAS、治疗后3个月生命活力及社会功能评分、治疗后排便时间均优于保守组(<0.05)。其他指标差异无统计学意义(>0.05)。手术组患者切口愈合良好,两组均未发生严重并发症。
经皮椎体成形术是治疗以脊柱源性腹痛为主要症状的骨质疏松性椎体压缩骨折的有效方法。与保守治疗相比,经皮椎体成形术在早期缓解腹痛及便秘、恢复生命活力及社会功能方面更具优势。