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胸腰筋膜损伤对经皮椎体成形术后报告结果的影响。

Effect of thoracolumbar fascia injury on reported outcomes after percutaneous vertebroplasty.

作者信息

Yang Songbo, Tang Jie, Yang Zhaoyi, Jin Hongju, Wang Qinglei, Wang Huiming

机构信息

Department of Orthopedics, Beijing Geriatric Hospital, Beijing, China.

出版信息

Front Surg. 2024 May 16;11:1379769. doi: 10.3389/fsurg.2024.1379769. eCollection 2024.

Abstract

PURPOSE

Thoracolumbar fascia injury is often associated with poor early pain relief after percutaneous vertebroplasty (PVP). This study will evaluate the effects of thoracolumbar fascia injury on early pain relief and time to get out of bed after PVP.

METHODS

A total of 132 patients treated with PVP for osteoporotic vertebral compression fractures (OVCF) were included and divided into injured group (52 cases) and non-injured group (80 cases) according to the existence of thoracolumbar fascia injury. Before surgery, 1 day, 3 days, 1 week, 1 month, and 3 months after surgery, and at the last follow-up, the primary patient-reported outcome measures (PROMs) were the visual analogue scale (VAS) of pain while rolling over and standing, and the secondary PROMs was the Oswestry disability index (ODI). Meanwhile, the achieved rate of minimal clinically important differences (MCID) and patient acceptable symptom states (PASS) of the above measures in both groups was evaluated at the last follow-up.

RESULTS

Except for the postoperative 3 months and the last follow-up, there were statistically significant differences in VAS-standing and ODI between the two groups at other time points after surgery ( < 0.05), and the non-injured group was significantly better than the injured group. At the last follow-up, there was no statistically significant difference in the MCID and PASS achievement rates of the above measures between the two groups ( > 0.05). In addition, the proportion of patients who got out of bed 1 and 3 days after surgery in the non-injury group was significantly higher than that in the injury group ( = 0.000 for both).

CONCLUSION

Thoracolumbar fascia injury significantly affected early pain relief and extended time of getting out of bed after PVP. Attention should be paid to preoperative evaluation of thoracolumbar fascial injury in order to better predict the postoperative efficacy of PVP.

摘要

目的

胸腰段筋膜损伤常与经皮椎体成形术(PVP)后早期疼痛缓解不佳相关。本研究将评估胸腰段筋膜损伤对PVP后早期疼痛缓解及下床时间的影响。

方法

共纳入132例因骨质疏松性椎体压缩骨折(OVCF)接受PVP治疗的患者,根据胸腰段筋膜损伤情况分为损伤组(52例)和未损伤组(80例)。在术前、术后1天、3天、1周、1个月、3个月及末次随访时,主要的患者报告结局指标(PROMs)为翻身和站立时的视觉模拟疼痛评分(VAS),次要PROMs为Oswestry功能障碍指数(ODI)。同时,在末次随访时评估两组上述指标的最小临床重要差异(MCID)达成率和患者可接受症状状态(PASS)。

结果

除术后3个月及末次随访外,两组术后其他时间点的VAS站立评分和ODI差异有统计学意义(<0.05),未损伤组明显优于损伤组。末次随访时,两组上述指标的MCID和PASS达成率差异无统计学意义(>0.05)。此外,未损伤组术后1天和3天下床患者比例明显高于损伤组(两者均为=0.000)。

结论

胸腰段筋膜损伤显著影响PVP后的早期疼痛缓解并延长下床时间。应重视术前对胸腰段筋膜损伤的评估,以更好地预测PVP术后疗效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf77/11137208/4c997aedff71/fsurg-11-1379769-g001.jpg

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