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椎体成形术和后凸成形术治疗老年骨质疏松性椎体压缩骨折:对健康相关生活质量的评估

Vertebroplasty and kyphoplasty in the management of osteoporotic vertebral compression fractures in elderly individuals: evaluation of the health-related quality of life.

作者信息

Kapetanakis Stylianos, Chaniotakis Constantinos, Zavridis Periklis, Kopsidas Periklis, Apostolakis Sotirios, Gkantsinikoudis Nikolaos

机构信息

Spine Department and Deformities, Interbalkan European Medical Center, Thessaloniki,Greece; Department of Minimally Invasive and Endoscopic Spine Surgery, Athens Medical Center, Athens.

Spine Department and Deformities, Interbalkan European Medical Center, Thessaloniki.

出版信息

Eur J Transl Myol. 2024 Aug 8;34(3):12274. doi: 10.4081/ejtm.2024.12274.

Abstract

Aim of this study is to investigate the safety, efficacy and impact on Health-Related Quality of Life (HRQoL) of Vertebroplasty (VP) and Kyphoplasty (KP) in the management of Osteoporotic Vertebral Compression Fractures (OVCFs) in elderly individuals. VP and KP represent Minimally Invasive Vertebral Augmentation (MIVA) procedures that are increasingly implemented for surgical treatment of OVCFs in recent years. These interventions have been associated with minimal traumatization and intraoperative hemorrhage, considerable analgesic effect and rapid postoperative recovery. Seventy-seven (77) consecutive individuals with OVCFs were subjected to VP/KP and recruited in this prospectively designed non-randomized study. Clinical evaluation was performed preoperatively and postoperatively at particular chronic intervals at 1, 6 weeks and at 3, 6, 12 months and 2 years. Assessment was conducted via the standardized Visual Analogue Scale (VAS) and Short-Form 36 (SF-36) Medical Health Survey Questionnaire for pain and HRQoL, respectively. No perioperative complications were observed. All studied indices were demonstrated to present a statistically significant amelioration following overall analysis. Pain intensity measured by the VAS score was depicted to be significantly reduced during the first 3 months, but continuous improvement of all indices of SF-36 and VAS was demonstrated to reach a plateau at 6 months, featuring no further clinical improvement.VP and KP represent safe and efficient options for interventional treatment of OVCFs in elderly and oldest-old patients, improving self-reported symptoms of pain as well as overall HRQoL.

摘要

本研究旨在调查椎体成形术(VP)和后凸成形术(KP)治疗老年骨质疏松性椎体压缩骨折(OVCFs)的安全性、有效性以及对健康相关生活质量(HRQoL)的影响。VP和KP是近年来越来越多地用于OVCFs手术治疗的微创椎体增强(MIVA)手术。这些干预措施创伤小、术中出血少、镇痛效果显著且术后恢复快。77例连续的OVCFs患者接受了VP/KP手术,并纳入了这项前瞻性设计的非随机研究。术前以及术后在1、6周以及3、6、12个月和2年的特定慢性时间间隔进行临床评估。分别通过标准化视觉模拟量表(VAS)和简短健康调查问卷36项(SF-36)对疼痛和HRQoL进行评估。未观察到围手术期并发症。总体分析显示,所有研究指标均有统计学意义的改善。VAS评分测量的疼痛强度在最初3个月内显著降低,但SF-36和VAS的所有指标在6个月时持续改善达到平台期,此后无进一步临床改善。对于老年和高龄患者的OVCFs介入治疗,VP和KP是安全有效的选择,可改善自我报告的疼痛症状以及总体HRQoL。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8e4/11487666/5f18bf96a639/ejtm-34-3-12274-g001.jpg

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