性别对症状性椎体脆性骨折治疗后疼痛和生活质量演变的影响。
Effect of gender on the evolution of pain and quality of life after treatment of symptomatic vertebral fragility fractures.
机构信息
Rheumatology and Neurointerventional Departments, Hospital Clínic, University of Barcelona, Villarroel 170, 08036, Barcelona, Spain.
Departament de Medicina, Facultad de Medicina i Ciencias de la Salut, Universitat de Barcelona, Barcelona, Spain.
出版信息
Osteoporos Int. 2024 Mar;35(3):515-521. doi: 10.1007/s00198-023-06960-y. Epub 2023 Nov 30.
UNLABELLED
The evolution of pain and quality of life after a symptomatic vertebral fracture differs according to patient gender, with a worse evolution in women independently of the treatment received.
PURPOSE
In a previous randomized clinical study comparing the effect of vertebroplasty (VP) vs. conservative therapy (CT) on pain evolution and quality of life (QoL) of patients with symptomatic vertebral fractures (VF), we observed the development of chronic back pain in 23% of subjects, independently of the therapy received. This study analyses the effect of gender on the evolution of pain and QoL in these subjects.
METHODS
118/125 randomized patients (27 males/91 females) with recent symptomatic VFs were evaluated. All received a standardized analgesic and antiosteoporotic format of treatment. Pain and QoL were evaluated by VAS and Qualeffo-41, respectively, at baseline, at 2 weeks and 2 and 6 months. We compared pain evolution and QoL after treatment (CT vs. VP) according to gender, and analysed factors including age, time of evolution, treatment received, baseline VAS, previous VFs (total and recent), incidental VFs, lumbar and femoral T-scores, and analgesic and antiosteoporotic treatment.
RESULTS
At baseline, there were no differences in age (males 74.8 ± 11.2 vs. females:73.2 ± 8.7 years), time of evolution, number of VFs (males:3.8 ± 2.4 vs. females: 3.1 ± 2.4), treatment received (VP, males:59%, females:45%), lumbar or femoral T-score, baseline VAS (males:6.8 ± 2.1 vs. females:6.8 ± 2.2) or Qualeffo score (males:52.2 ± 24.4 vs. females:59.7 ± 20.6). Pain and QoL evolution differed according to gender, being better in males. These differences were significant after two months independently of the treatment and the development of incidental VF during follow-up.
CONCLUSIONS
Pain and QoL evolution after a symptomatic VF differs according to gender, with a worse evolution in women independently of the treatment received.
背景
椎体骨折后疼痛和生活质量的演变因患者性别而异，女性无论接受何种治疗，其演变都更差。
目的
在一项比较经皮椎体成形术（VP）与保守治疗（CT）对有症状性椎体骨折（VF）患者疼痛演变和生活质量（QoL）影响的随机临床研究中，我们观察到 23%的受试者出现慢性背痛，与所接受的治疗无关。本研究分析了性别对这些患者疼痛和 QoL 演变的影响。
方法
对 125 例随机患者（27 例男性/91 例女性）的近期有症状性 VF 进行评估。所有患者均接受标准化镇痛和抗骨质疏松治疗。基线、治疗后 2 周和 2、6 个月时，分别采用视觉模拟评分（VAS）和 Qualeffo-41 评估疼痛和 QoL。我们根据性别比较治疗后（CT 与 VP）的疼痛演变和 QoL，并分析包括年龄、发病时间、治疗方式、基线 VAS、既往 VF（总数和近期）、偶然 VF、腰椎和股骨 T 评分以及镇痛和抗骨质疏松治疗在内的相关因素。
结果
基线时，两组患者的年龄（男性 74.8±11.2 岁，女性 73.2±8.7 岁）、发病时间、VF 数量（男性 3.8±2.4 个，女性 3.1±2.4 个）、治疗方式（VP，男性 59%，女性 45%）、腰椎或股骨 T 评分、基线 VAS（男性 6.8±2.1，女性 6.8±2.2）或 Qualeffo 评分（男性 52.2±24.4，女性 59.7±20.6）无差异。性别不同，疼痛和 QoL 演变也不同，男性患者改善更明显。无论治疗方式如何，这种差异在治疗后 2 个月时即已显著存在，且在随访过程中发生偶然 VF 时更为显著。
结论
有症状性 VF 后疼痛和生活质量的演变因性别而异，女性无论接受何种治疗，其演变都更差。
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