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骨质疏松性椎体压缩骨折伴或不伴肌肉减少症患者经皮椎体后凸成形术临床效果的比较:一项回顾性队列研究

Comparison Between the Clinical Effect of Percutaneous Kyphoplasty for Osteoporosis Vertebral Compression Fracture Patient with or Without Sarcopenia: A Retrospective Cohort Study.

作者信息

Peng Yujie, Wu Xiaochuan, Ma Xinyu, Xu Dingli, Wang Yang, Xia Dongdong

机构信息

Orthopeadic Department, The First Affiliated Hospital of Ningbo University, Ningbo, People's Republic of China.

Emergency Department, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, People's Republic of China.

出版信息

Int J Gen Med. 2023 Jul 21;16:3095-3103. doi: 10.2147/IJGM.S423016. eCollection 2023.

Abstract

BACKGROUND

Sarcopenia and osteoporosis vertebral compression fractures (OVCF) are common diseases that increase with age. This study aimed to investigate the effects of sarcopenia on OVCF patients after percutaneous kyphoplasty (PKP).

METHODS

Data of 101 patients who were treated with single-level PKP between January 2021 and March 2022 at Ningbo No.6 Hospital were enrolled. Forty-five OVCF patients with sarcopenia who met our inclusion criteria were included in the Sarcopenia-PKP group (SPKP group), and 56 patients in the Normal-PKP group (NPKP group). All clinical and radiological data were collected from medical records. Baseline characteristics, operation-related parameters (operation time, time to ambulation, hospital stay, surgery segment), clinical outcomes (visual analog score [VAS], Oswestry Disability Index [ODI], Japanese Orthopaedic Association Scores [JOA] of lumber), radiological outcomes (vertebral anterior height rate and local kyphosis angle), Macnab score, and complications were evaluated and compared.

RESULTS

There were no significant differences in age, sex, surgical segment preoperative VAS score, ODI, or JOA between the two groups (P > 0.05). The SPKP group had a significantly lower body mass index (BMI), bone mineral density (BMD), and smooth muscle index (SMI) than the NPKP group (P < 0.05). Significantly longer hospital stays and time to ambulation in SPKP group than NPKP group (3.7±0.8 vs 3.4±0.5 and 2.0±0.8 vs 1.6±0.5, P < 0.05). In SPKP group, significantly better clinical outcomes at 6- and 12-months follow-up were observed in NPKP group than SPKP group (P < 0.05), and NPKP group showed significantly better in vertebral anterior height rates than SPKP group after 6-month follow-up (P < 0.05). Moreover, there were significantly more cases of complications in the SPKP group (P < 0.05).

CONCLUSION

Sarcopenia could reduce the clinical effect of percutaneous kyphoplasty, and furthermore. Related studies are needed to verify the effect of sarcopenia on OVCF patients.

摘要

背景

肌肉减少症和骨质疏松性椎体压缩骨折(OVCF)是随着年龄增长而增加的常见疾病。本研究旨在探讨肌肉减少症对经皮椎体后凸成形术(PKP)治疗的OVCF患者的影响。

方法

纳入2021年1月至2022年3月在宁波市第六医院接受单节段PKP治疗的101例患者的数据。45例符合纳入标准的伴有肌肉减少症的OVCF患者被纳入肌肉减少症-PKP组(SPKP组),56例患者被纳入正常-PKP组(NPKP组)。所有临床和放射学数据均从病历中收集。评估并比较基线特征、手术相关参数(手术时间、下床活动时间、住院时间、手术节段)、临床结局(视觉模拟评分[VAS]、Oswestry功能障碍指数[ODI]、腰椎日本骨科协会评分[JOA])、放射学结局(椎体前缘高度率和局部后凸角)、Macnab评分及并发症。

结果

两组患者在年龄、性别、手术节段、术前VAS评分、ODI或JOA方面无显著差异(P>0.05)。SPKP组的体重指数(BMI)、骨密度(BMD)和平滑肌指数(SMI)显著低于NPKP组(P<0.05)。SPKP组的住院时间和下床活动时间显著长于NPKP组(3.7±0.8 vs 3.4±0.5和2.0±0.8 vs 1.6±0.5,P<0.05)。在SPKP组中,随访6个月和12个月时NPKP组的临床结局显著优于SPKP组(P<0.05),随访6个月后NPKP组的椎体前缘高度率显著优于SPKP组(P<0.05)。此外,SPKP组的并发症病例明显更多(P<0.05)。

结论

肌肉减少症会降低经皮椎体后凸成形术的临床效果,此外,还需要相关研究来验证肌肉减少症对OVCF患者的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/992f/10368018/1fa5958f7812/IJGM-16-3095-g0001.jpg

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