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老年急性椎体压缩骨折行椎体成形术后矢状位脊柱排列的短期变化及其与巴氏指数变化的关系

The Short-Term Changes of the Sagittal Spinal Alignments After Acute Vertebral Compression Fracture Receiving Vertebroplasty and Their Relationship With the Change of Bathel Index in the Elderly.

作者信息

Su Wen-Chin, Wu Wen-Tien, Peng Cheng-Huan, Yu Tzai-Chiu, Lee Ru-Ping, Wang Jen-Hung, Yeh Kuang-Ting

机构信息

Department of Orthopedics, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.

School of Medicine, Tzu Chi University, Hualien, Taiwan.

出版信息

Geriatr Orthop Surg Rehabil. 2022 May 6;13:21514593221100238. doi: 10.1177/21514593221100238. eCollection 2022.

Abstract

INTRODUCTION

Fragility vertebral compression fractures (VCFs) are of major concern due to aging populations worldwide, which may occur after a fall from standing or due to severe osteoporosis, impacting greatly the life quality of the elderly. This study thus determined the factors independently associated with poor functional recovery from a new VCF and changes in sagittal spinal alignment after vertebroplasty in elderly patients with osteoporosis.

MATERIALS AND METHODS

The data were collected from patients older than 70 years and diagnosed with a new VCF. Logistic regression analysis was performed to determine factors independently associated with function and radiographic status.

RESULTS

We enrolled 8 male and 34 female patients with a mean age of 80.74 ± 8.31 years between January and July 2020. Compared with preoperative data, post-vertebroplasty lumbar sagittal alignments and functional scores improved significantly, and function recovered gradually over 12 weeks. Climbing stairs was the most influential performance indicator at the beginning of the recovery process. At each postoperative follow-up, changes in the C7-sacrum sagittal vertical axis exhibited an influence on functional recovery. Male patients were better able to move from a chair to a bed at the 2-week postoperative follow-up, and positive changes in the spino-sacral angle led to improved function in terms of stair climbing at the 6-week postoperative follow-up.

CONCLUSIONS

Vertebroplasty seemed to be effective for functional recovery related to sagittal spinal alignment improvement of the elderly with VCFs during postoperative 12 weeks, which may be a critical stage for the recovery for their life activities. The recovery rate for stair climbing after vertebroplasty was slower than for the other functional performance indicators in our study. In addition, if a patient was unable to demonstrate a marked improvement in sagittal alignment, they were likely to have ongoing impaired function and a poor prognosis after surgery.

摘要

引言

由于全球人口老龄化,脆性椎体压缩骨折(VCF)备受关注,其可能因从站立位跌倒或严重骨质疏松而发生,对老年人的生活质量影响极大。因此,本研究确定了老年骨质疏松性椎体压缩骨折患者椎体成形术后功能恢复不佳及矢状面脊柱排列变化的独立相关因素。

材料与方法

收集70岁以上诊断为新发椎体压缩骨折患者的数据。进行逻辑回归分析以确定与功能及影像学状态独立相关的因素。

结果

2020年1月至7月,我们纳入了8例男性和34例女性患者,平均年龄为80.74±8.31岁。与术前数据相比,椎体成形术后腰椎矢状面排列和功能评分显著改善,且功能在12周内逐渐恢复。在恢复过程开始时,爬楼梯是最具影响力的表现指标。在每次术后随访中,C7-骶骨矢状垂直轴的变化对功能恢复有影响。男性患者在术后2周时从椅子移动到床上的能力更好,而棘-骶角的正向变化导致术后6周时爬楼梯功能改善。

结论

椎体成形术似乎对老年椎体压缩骨折患者术后12周内与矢状面脊柱排列改善相关的功能恢复有效,这可能是其生活活动恢复的关键阶段。在我们的研究中,椎体成形术后爬楼梯的恢复速度比其他功能表现指标慢。此外,如果患者矢状面排列未能显著改善,则术后功能可能持续受损且预后不良。

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本文引用的文献

1
Readmissions of Elder Patients Presenting to Hospital for a Fall (RELIEF): A Systematic Review.
J Am Med Dir Assoc. 2020 Oct;21(10):1451-1457.e6. doi: 10.1016/j.jamda.2020.04.025. Epub 2020 Jul 12.
2
The importance of sagittal balance in adult scoliosis surgery.
Ann Transl Med. 2020 Jan;8(2):35. doi: 10.21037/atm.2019.10.19.
5
Osteoporotic vertebral fractures: predictive factors for conservative treatment failure. A systematic review.
Eur Spine J. 2018 Oct;27(10):2565-2576. doi: 10.1007/s00586-017-5340-z. Epub 2017 Oct 13.
7
Worldwide prevalence and incidence of osteoporotic vertebral fractures.
Osteoporos Int. 2017 May;28(5):1531-1542. doi: 10.1007/s00198-017-3909-3. Epub 2017 Feb 6.
8
Correlation analysis of osteoporotic vertebral compression fractures and spinal sagittal imbalance.
Orthopade. 2017 Mar;46(3):249-255. doi: 10.1007/s00132-016-3359-1.
9
Comparison of effectiveness of kyphoplasty and vertebroplasty in patients with osteoporotic vertebra fractures.
Acta Orthop Traumatol Turc. 2016 Dec;50(6):619-622. doi: 10.1016/j.aott.2016.10.002. Epub 2016 Oct 25.
10
Sagittal alignment of the spine: What do you need to know?
Clin Neurol Neurosurg. 2015 Dec;139:295-301. doi: 10.1016/j.clineuro.2015.10.024. Epub 2015 Oct 28.

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