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早期活动与至少1周绝对卧床休息治疗骨质疏松性椎体压缩骨折的对比研究

A Comparative Study on the Treatment of Osteoporotic Vertebral Compression Fractures With Early Ambulation and at Least 1 Week of Absolute Bed Rest.

作者信息

Kim Gi Hun, Cho Tack Geun

机构信息

Department of Neurosurgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.

出版信息

Korean J Neurotrauma. 2022 Mar 10;18(1):56-63. doi: 10.13004/kjnt.2022.18.e13. eCollection 2022 Apr.

Abstract

OBJECTIVE

This study aimed to determine whether absolute bed rest (ABR) is essential for the conservative treatment of osteoporotic vertebral compression fractures (OVCFs).

METHODS

This study included 115 patients diagnosed with OVCFs. The patients in group A were allowed to ambulate as soon as possible, while those in group B underwent ABR for at least 1 week. X-ray images at baseline and 1 week, 2 weeks, 1 month, 3 months, and 6 months after trauma were obtained from both groups for assessment. In each group, ABR-related complications including constipation, indigestion, Foley catheter insertion, urinary tract infection, cough/sputum, dizziness, and neurasthenia were investigated.

RESULTS

In both groups, the compression rates, Cobb angles, and visual analog scale scores did not differ significantly at baseline and the first, second, third, fourth, and fifth follow-ups. In terms of constipation, indigestion, dizziness, and neurasthenia, group A reported a significantly higher complication rate than group B (<0.05).

CONCLUSION

The prognosis did not differ significantly between patients who underwent ABR for at least 1 week and those who started walking as soon as possible. The incidence of complications due to ABRs was lower in the early ambulatory group. Therefore, it may be helpful to start walking as early as possible during the conservative treatment of OVCFs.

摘要

目的

本研究旨在确定绝对卧床休息(ABR)对于骨质疏松性椎体压缩骨折(OVCFs)保守治疗是否必不可少。

方法

本研究纳入了115例诊断为OVCFs的患者。A组患者尽早允许活动,而B组患者进行至少1周的ABR。两组均获取创伤后基线及1周、2周、1个月、3个月和6个月时的X线图像进行评估。在每组中,调查与ABR相关的并发症,包括便秘、消化不良、导尿管插入、尿路感染、咳嗽/咳痰、头晕和神经衰弱。

结果

两组在基线及首次、第二次、第三次、第四次和第五次随访时,压缩率、Cobb角和视觉模拟评分均无显著差异。在便秘、消化不良、头晕和神经衰弱方面,A组报告的并发症发生率显著高于B组(<0.05)。

结论

接受至少1周ABR的患者与尽早开始行走的患者之间预后无显著差异。早期活动组因ABR导致的并发症发生率较低。因此,在OVCFs保守治疗期间尽早开始行走可能有益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b280/9064757/f3acc7b7f1fc/kjn-18-56-g001.jpg

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