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骨质疏松性椎体骨折中的胸腰椎筋膜损伤:重要的伴随性损伤。

Thoracolumbar fascia injury in osteoporotic vertebral fracture: the important concomitant damage.

机构信息

The authors are from the Department of Orthopaedic Surgery, the First Affiliated Hospital of Soochow University, NO. 899, Pinghai Road, Suzhou, 215006, Jiangsu, China.

出版信息

BMC Musculoskelet Disord. 2023 Mar 6;24(1):166. doi: 10.1186/s12891-023-06280-6.

Abstract

BACKGROUND

Thoracolumbar fascia injury (FI) is rarely discussed in osteoporotic vertebral fracture (OVF) patients in previous literature and it is usually neglected and treated as an unmeaning phenomenon. We aimed to evaluate the characteristics of the thoracolumbar fascia injury and further discuss its clinical significance in the treatment of kyphoplasty for osteoporotic vertebral fracture (OVF) patients.

METHODS

Based on the presence or absence of FI, 223 OVF patients were divided into two groups. The demographics of patients with and without FI were compared. The visual analogue scale and Oswestry disability index scores were compared preoperatively and after PKP treatment between these groups.

RESULTS

Thoracolumbar fascia injuries were observed in 27.8% of patients. Most FI showed a multi-level distribution pattern which involved a mean of 3.3 levels. Location of fractures, severity of fractures and severity of trauma were significantly different between patients with and without FI. In further comparison, severity of trauma was significantly different between patients with severe and non-severe FI. In patients with FI, VAS and ODI scores of 3 days and 1 month after PKP treatment were significantly worse compared to those without FI. It showed the same trend in VAS and ODI scores in patients with severe FI when compared to those patients with non-severe FI.

CONCLUSIONS

FI is not rare in OVF patients and presents multiple levels of involvement. The more serious trauma suffered, the more severe thoracolumbar fascia injury presented. The presence of FI which was related to residual acute back pain significantly affected the effectiveness of PKP in treating OVFs.

TRIAL REGISTRATION

retrospectively registered.

摘要

背景

在先前的文献中,胸腰筋膜损伤(FI)在骨质疏松性椎体骨折(OVF)患者中很少被讨论,通常被忽视并视为无意义的现象。我们旨在评估胸腰筋膜损伤的特征,并进一步探讨其在骨质疏松性椎体骨折(OVF)患者经皮椎体后凸成形术(PKP)治疗中的临床意义。

方法

根据 FI 的存在与否,将 223 例 OVF 患者分为两组。比较 FI 患者和无 FI 患者的人口统计学特征。比较两组患者术前和 PKP 治疗后的视觉模拟评分(VAS)和 Oswestry 功能障碍指数(ODI)评分。

结果

27.8%的患者出现胸腰筋膜损伤。大多数 FI 呈多节段分布,平均累及 3.3 个节段。FI 患者与无 FI 患者的骨折部位、骨折严重程度和创伤严重程度存在显著差异。进一步比较发现,FI 患者中严重 FI 与非严重 FI 患者的创伤严重程度存在显著差异。在有 FI 的患者中,PKP 治疗后 3 天和 1 个月的 VAS 和 ODI 评分明显差于无 FI 的患者。严重 FI 患者的 VAS 和 ODI 评分与非严重 FI 患者的评分趋势相同。

结论

FI 在 OVF 患者中并不罕见,表现为多节段受累。创伤越严重,胸腰筋膜损伤越严重。FI 的存在与残余急性腰痛显著相关,影响了 PKP 治疗 OVF 的效果。

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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6f6/9987111/5785c913e9c7/12891_2023_6280_Fig1_HTML.jpg

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