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中华老年病研究电子杂志 ›› 2021, Vol. 08 ›› Issue (02) : 30 -34. doi: 10.3877/cma.j.issn.2095-8757.2021.02.006

论著

腰背部筋膜损伤对老年骨质疏松性椎体压缩骨折患者椎体成形术早期疗效的影响
谢亚明1, 杨永竑1, 陈标1, 袁航1,()   
  1. 1. 310013 杭州,浙江医院骨科中心
  • 收稿日期:2020-12-20 出版日期:2021-05-28
  • 通信作者: 袁航

Effects of lumbar and dorsal fascia injury on the early outcome of percutaneous vertebroplasty in elderly patients with osteoporotic vertebral compression fractures

Yaming Xie1, Yonghong Yang1, Biao Chen1, Hang Yuan1,()   

  1. 1. Orthopedic Center, Zhejiang Hospital, Hangzhou 310013, China
  • Received:2020-12-20 Published:2021-05-28
  • Corresponding author: Hang Yuan
引用本文:

谢亚明, 杨永竑, 陈标, 袁航. 腰背部筋膜损伤对老年骨质疏松性椎体压缩骨折患者椎体成形术早期疗效的影响[J/OL]. 中华老年病研究电子杂志, 2021, 08(02): 30-34.

Yaming Xie, Yonghong Yang, Biao Chen, Hang Yuan. Effects of lumbar and dorsal fascia injury on the early outcome of percutaneous vertebroplasty in elderly patients with osteoporotic vertebral compression fractures[J/OL]. Chinese Journal of Geriatrics Research(Electronic Edition), 2021, 08(02): 30-34.

目的

探讨腰背部筋膜损伤对老年骨质疏松性椎体压缩骨折(osteoporosis vertebral compression fractures, OVCF)患者椎体成形术(percutaneous vertebroplasty, PVP)早期疗效的影响。

方法

选取科2018年9月至2020年9月浙江医院收治的行PVP治疗的OVCF患者229例,根据腰背部筋膜损伤情况分为筋膜损伤组(82例)和非筋膜损伤组(147例)。比较两组患者手术前后的疼痛视觉模拟评分(visual analogue scale, VAS)和翻身活动情况。组间各时点VAS的比较采用重复测量方差分析,计数资料的组间比较采用χ2检验。

结果

手术治疗后,VAS的组间、时间以及交互作用的整体差异均有统计学意义(F=21.578、1 580.589、5.953,P<0.01)其中组间差异表现为筋膜损伤组患者手术后VAS在各随访时间点均明显高于无筋膜损伤组时间差异表现为两组患者手术后VAS随着时间推移呈明显下降趋势。两组患者手术前后各时点翻身痛阳性率的差异均无统计学意义(χ2=0.100、3.314、0.531、0.000、0.000,P>0.05)。

结论

腰背部筋膜损伤可能是引起老年OVCF患者PVP后残余痛的原因之一,从而影响了术后早期疗效。

Objective

To investigate the effects of lumbar and dorsal fascia injury on the early outcome of percutaneous vertebroplasty (PVP) in elderly patients with osteoporotic vertebral compression fractures (OVCF).

Methods

229 OVCF patients treated with PVP admitted to Zhejiang hospital from September 2018 to September 2020 were selected and divided into fascia injury group (82 cases) and non fascia injury group (147 cases) according to the fascia injury of low back. The visual analogue scale (VAS) of pain and roll over activities before and after operation were compared between the two groups. VAS at each time point was compared by repeated measurement analysis of variance, and count data was compared by χ2 test.

Results

After surgical treatment, the overall differences of VAS between groups, time and interaction were statistically significant (F=21.578, 1580.589, 5.953, P < 0.01). The inter-group effect showed that the VAS in the fascia injury group was significantly higher than that in the non-fascia injury group at all follow-up time points. The time effect showed that the VAS of the two groups decreased significantly with time. There was no significant difference in the positive rate of rolling pain between the two groups at each time point before and after operation (χ2=0.100, 3.314、0.531, 0.000, 0.000, P > 0.05).

Conclusion

Lumbar and dorsal fascia injury may be one of the causes of residual pain after PVP in elderly OVCF patients, which affects the early postoperative efficacy.

表1 两组患者一般情况的比较
图1 腰背部筋膜损伤的MRI表现。图1a、b、c:T12椎体压缩性骨折,不伴有腰背部筋膜损伤;腰背部筋膜未见T1WI低信号,T2WI高信号,T2W-SPAIR序列高信号的损伤征象。图1d、e、f:L3椎体压缩性骨折,伴有腰背部筋膜损伤;腰背部筋膜可见T1WI低信号,T2WI高信号,T2W-SPAIR序列高信号的损伤征象
图2 典型OVCF病例手术前后影像学检查所见。图2a为术前MRI检查所见,图2b为术后X线片检查所见,图2c为术后6个月MRI复查所见
表2 两组患者手术治疗前后的VAS(分,±s
表3 两组患者手术治疗前后翻身痛发生情况的比较[例(%)]
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