Xinyu Guo, Na Zhu, Haihong Zhang, Dingjun Hao
Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, China.
Shaanxi Key Laboratory of Spine Bionic Treatment, Xi'an Jiaotong University, Xi'an, China.
Front Surg. 2023 Jan 10;9:1056729. doi: 10.3389/fsurg.2022.1056729. eCollection 2022.
The aim of the study was to examine the clinical incidence rate of vertebral body fractures after percutaneous vertebroplasty (PVP) with and without brace wearing and provide a new guiding ideology for preventing vertebral fractures after clinical surgeries.
The retrospective analysis included 100 outpatients who underwent PVP between January 2017 and December 2018 without bracing after PVP surgeries (non-brace-wearing group). In total, 100 patients were paired into the rigid brace group and 100 patients were paired into the soft braces group according to propensity score matching. Seven independent variables were used in the soft and rigid brace group: age, sex, body mass index (BMI), visual analog scale (VAS), Oswestry Disability Index (ODI), and Cobb angle. The VAS, ODI, and Japanese Orthopaedic Association (JOA) scores were recorded preoperatively on the second day, after 1 month, after 3 months, and during the last follow-up postoperatively. We recorded the incidence of vertebral refracture in each of the three groups of patients and evaluated the effect of braces on postoperative fractures based on the ODI, VAS, and JOA scores.
All patients were followed up for 8-24 months (mean 22.4 months). Compared with the preoperative values, the age, sex, BMI, bone density, ODI, VAS, and Cobb angle between refracture and non-refracture were not statistically significant. The VAS, ODI, and JOA scores significantly increased in the brace-wearing group compared with those of the non-brace-wearing group ( < 0.05). The incidence of vertebral refracture in the brace-wearing group was lower than that in the non-brace-wearing group, between which there was a significant difference ( < 0.05). Three months postoperatively, the JOA score of the soft brace group was significantly higher than that of the rigid brace group ( < 0.05). During the last follow-up, it was found that there was no difference in the VAS score, the incidence of refracture, or ODI between the soft brace group and the rigid brace group ( > 0.05). The improvement in the JOA score of the soft brace group was better than that of the rigid brace group, between which there was a significant difference ( < 0.05).
Braces can improve the prognosis of quality of life and postoperative subjective perception, whose presence can relieve postoperative residual pains. In contrast, patients can have a better medical experience wearing a soft brace.
本研究旨在探讨经皮椎体成形术（PVP）后佩戴与不佩戴支具情况下椎体骨折的临床发生率，为临床术后预防椎体骨折提供新的指导思想。
回顾性分析2017年1月至2018年12月期间接受PVP手术且术后未佩戴支具的100例门诊患者（非佩戴支具组）。根据倾向得分匹配，将100例患者配对入硬质支具组，100例患者配对入软质支具组。软质和硬质支具组使用7个独立变量：年龄、性别、体重指数（BMI）、视觉模拟评分（VAS）、Oswestry功能障碍指数（ODI）和Cobb角。术前、术后第2天、1个月后、3个月后及末次随访时记录VAS、ODI和日本骨科学会（JOA）评分。记录三组患者中椎体再骨折的发生率，并根据ODI、VAS和JOA评分评估支具对术后骨折的影响。
所有患者均随访8 - 24个月（平均22.4个月）。与术前值相比，再骨折组与未再骨折组之间的年龄、性别、BMI、骨密度、ODI、VAS和Cobb角无统计学差异。与非佩戴支具组相比，佩戴支具组的VAS、ODI和JOA评分显著升高（<0.05）。佩戴支具组的椎体再骨折发生率低于非佩戴支具组，两者之间存在显著差异（<0.05）。术后3个月，软质支具组的JOA评分显著高于硬质支具组（<0.05）。在末次随访时，发现软质支具组与硬质支具组之间的VAS评分、再骨折发生率或ODI无差异（>0.05）。软质支具组JOA评分的改善优于硬质支具组，两者之间存在显著差异（<0.05）。
支具可改善生活质量预后和术后主观感受，其存在可缓解术后残留疼痛。相比之下，患者佩戴软质支具可获得更好的就医体验。
