摘要
目的通过临床随机对照试验,比较经皮椎体成形术与保守疗法对骨质疏松性椎体压缩骨折的短期疗效,包括疼痛缓解程度、身心康复情况及邻近椎体再骨折的发生。方法 2007年1月-2010年1月间,纳入符合条件者40例,病程均在6周以内。随机分配成两组,试验组采用经皮椎体成形术,对照组采用保守治疗。进入试验前及进入试验后3个月时记录疼痛指数视觉模拟评分、下腰痛JOA评分、查体情况。结果治疗后两组视觉疼痛指数均下降,组内差异显著,组间差异不显著。试验组恢复生活自理能力更快。其他测试指标变化情况在两组之间亦无显著差异。试验组发生1例邻近椎体骨折,而对照组未发生。结论经皮椎体成形术早期疗效显著,但是保守治疗亦可在数月内取得相同疗效。邻近椎体再骨折的风险需要进一步评估。
Objective To compare percutaneous vertebroplasty（PVP）to conservative treatment of patients with osteoporotic vertebral fractures in a clinical randomized study with respect to pain,physical and mental outcome,and to asses the risk of adjacent vertebral fractures.Methods Forty patients were included from January 2007 until January 2010.Patients with osteoporotic fractures（ 6weeks）were included and randomized to either PVP or conservative treatment.Pain was assessed with a visual analogue scale and physical and mental outcome were assessed by validated questionnaires and tests.Tests,questionnaires,and plain radiographs were performed at the inclusion and after 3 months.Results Reduction in pain from initial visit to 3-months follow-up was comparable in the 2 groups（P0.05）,intergroup difference was significan（tP0.05）.In the PVP group,patients recovered soon.There was no significant difference in the other parameters when comparing the results at inclusion and after 3 months within both groups and between the groups after 3 months with a few exceptions.We observed 1 adjacent vertebral fracture in the PVP group and non in the conservative group.Conclusion The majority of patients with acute or subacute painful osteoporotic compression fracture of the spine will recover after a few months of conservative treatment.The risk of adjacent fractures needs further research.
出处
《颈腰痛杂志》
2010年第5期323-326,共4页
The Journal of Cervicodynia and Lumbodynia
