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经皮椎体成形术与保守治疗骨质疏松性椎体压缩骨折的长期疗效:一项为期三年随访的回顾性队列研究

Long-term outcome of percutaneous vertebroplasty versus conservative treatment for osteoporotic vertebral compression fractures: a retrospective cohort study with three-year follow-up.

作者信息

Chen Zefu, Xu Lei, Shi Liang, Cao HongXia, Nie Mingxi

机构信息

Department of Emergency, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang, China.

Department of Orthopedics, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang, China.

出版信息

Front Med (Lausanne). 2024 May 3;11:1391243. doi: 10.3389/fmed.2024.1391243. eCollection 2024.

Abstract

BACKGROUND

Osteoporotic vertebral compression fractures (OVCF) appear to be more common as the population ages. Previous studies have found that percutaneous vertebroplasty (PVP) can achieve better short-term clinical outcomes than conservative treatment (CT) for OVCF. However, the long-term outcomes of PVP compared with CT for OVCF has been rare explored. This study was designed to explore the clinical outcomes of PVP or CT within 3 years after OVCF.

METHODS

This study reviewed the clinical outcomes of patients who underwent PVP or CT for OVCF in a single center from January 2015 to December 2019. The back pain visual analogue scale (VAS), Oswestry disability index (ODI) and satisfaction rate were compared between the two groups at baseline, 1 week, 1 month, 3 months, 6 months, 12 months, 24 months and 36 months after treatment.

OUTCOMES

The baseline data including gender, age, bone mineral density, body mass index, back pain VAS, and ODI were not significantly different between the two groups. The back pain VAS and ODI of CT patients were significantly higher than those of PVP group at 1 week, 1 month, 3 months, 6 months and 12 months after treatment. The satisfaction rate in the PVP group were significantly higher than those in the CT group at 1 week, 1 month, 3 months and 6 months after treatment. Subsequently, the back pain VAS and ODI showed no significant difference between the two groups at 24 and 36 months. In addition, there was no significant difference in treatment satisfaction between the two groups at 36 months. There was no significant difference in the rate of new vertebral compression fractures between the two groups within 36 months after treatment.

CONCLUSION

The clinical outcomes within 12 months after PVP and patient satisfaction rate within 6 months after PVP were significantly higher than CT. However, during 12 months to 36 months, this advantage generated by PVP was gradually diluted over time. Compared with CT, the long-term effect of PVP on OVCF should not be overestimated.

摘要

背景

随着人口老龄化,骨质疏松性椎体压缩骨折(OVCF)似乎更为常见。先前的研究发现,对于OVCF,经皮椎体成形术(PVP)在短期临床疗效上优于保守治疗(CT)。然而,与CT相比,PVP治疗OVCF的长期疗效鲜有探讨。本研究旨在探讨OVCF后3年内PVP或CT的临床疗效。

方法

本研究回顾了2015年1月至2019年12月在单一中心接受PVP或CT治疗OVCF的患者的临床疗效。比较两组在治疗基线、治疗后1周、1个月、3个月、6个月、12个月、24个月和36个月时的背痛视觉模拟量表(VAS)、Oswestry功能障碍指数(ODI)和满意率。

结果

两组的基线数据,包括性别、年龄、骨密度、体重指数、背痛VAS和ODI,差异无统计学意义。治疗后1周、1个月、3个月、6个月和12个月时,CT组患者的背痛VAS和ODI显著高于PVP组。治疗后1周、1个月、3个月和6个月时,PVP组的满意率显著高于CT组。随后,在24个月和36个月时,两组的背痛VAS和ODI差异无统计学意义。此外,在36个月时,两组的治疗满意度差异无统计学意义。治疗后36个月内,两组新椎体压缩骨折发生率差异无统计学意义。

结论

PVP后12个月内的临床疗效及PVP后6个月内的患者满意率显著高于CT。然而,在12个月至36个月期间,PVP产生的这一优势会随着时间逐渐减弱。与CT相比,不应高估PVP对OVCF的长期疗效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/53f1/11099242/e87f6223485e/fmed-11-1391243-g001.jpg

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