Comparison of curative efficacy of percutaneous vertebroplasty and non-surgical treatment of type I acute symptomatic osteoporotic thoracolumbar fracture
10.3760/cma.j.cn501098-20210120-00058
- VernacularTitle:经皮椎体成形术与非手术治疗急性症状性骨质疏松性胸腰椎骨折分型Ⅰ型骨折的疗效比较
- Author:
Qingda LI
1
;
Junsong YANG
;
Lin GAO
;
Baorong HE
;
Tuanjiang LIU
;
Xuefang ZHANG
;
Jianan ZHANG
;
Xin TIAN
;
Changjun HE
;
Mingyi YANG
;
Yuan TUO
;
Dingjun HAO
Author Information
1. 延安大学医学院 716000
- Keywords:
Spinal fractures;
Aged;
Osteoporosis;
Vertebroplasty;
Occult fractures
- From:
Chinese Journal of Trauma
2021;37(6):541-548
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the clinical efficacy of percutaneous vertebroplasty (PVP) and non-surgical treatment of patients with type I fracture according to the acute symptomatic osteoporotic thoracolumbar fracture (ASOTLF) classification.Methods:A retrospective case-control study was used to analyze the clinical data of 115 patients with ASOTLF admitted to Honghui Hospital of Xi'an Jiaotong University from January 2015 to December 2018. There were 48 males and 67 females, aged 65-92 years [(75.3±8.5)years]. According to clinical symptoms and imaging characteristics, all patients were identified with type I fracture according to the ASOTLF classification. Injury segments were at T 6 to T 10 in 10 patients, at T 11 in 15, at T 12 in 26, at L 1 in 34, ay L 2 in 18, at L 3 in 7, and at L 4 in 5. A total of 73 patients received PVP combined with anti-osteoporosis treatment (surgery group), and 42 patients received non-surgery combined anti-osteoporosis treatment (non-surgery group). Before treatment, at 1 day, 1 month, 3 months, 6 months after treatment, and at the last follow-up, the visual analogue scale (VAS) was used to assess the pain, the Roland Morris Disability (RMD) score to assess the spinal function, and the Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO) score to evaluate the quality of life. The bone mineral density was compared between groups before treatment and at 1 year after treatment. The complications were observed as well. Results:All patients were followed up for 12-18 months [(13.2±4.6)months]. At 1 day, 1 month, and 3 months after treatment, the VAS in surgery group [(3.9±0.6)points, (3.3±0.6)points, (2.9±0.3)points] was significantly lower than that in non-surgery group [(6.0±0.7)points, (5.0±0.8)points, (4.2±1.0)points, respectively] (all P<0.05); the RMD score in surgery group [(15.2±0.7)points, (12.6±0.7)points, (10.6±0.7)points] was significantly lower than that in non-surgery group [(16.4±0.8)points, (14.6±0.8)points, (12.7±0.6)points, respectively] (all P<0.05). At 1 day and 1 month after treatment, the QUALEFFO score in surgery group [(46.0±1.1)points, (41.4±0.8)points] was lower than that in non-surgery group [(50.3±0.8)points, (44.7±1.2)points] (all P<0.05). There was no statistically significant difference between the two groups at other time points of the above indicators ( P>0.05). At 1 year after treatment, the bone mineral density in surgery group was (-3.0±0.9)SD, and was (-2.8±1.1)SD in non-surgery group ( P>0.05). There was no significant difference in the incidence of complications between surgery group [37%(27/73)] and non-surgery group [33%(14/42)] ( P>0.05). Conclusion:For patients with ASOTLF type I fracture, PVP and non-surgical treatment has similar effects in anti-osteoporosis and occurrence of complications, but the PVP is superior to non-surgical treatment in early pain relief, spinal function improvement and quality of life.
