经皮椎体成形术与保守疗法的临床随机对照试验.docVIP

经皮椎体成形术与保守疗法的临床随机对照试验Percutaneous Vertebroplasty Compared to Conservative Treatment in Patients with Osteoporotic Vertebral Compression Fractures陈刚 张松涛 刘永才 孙荣智 赵晓 罗丁 471000 洛阳 解放军第五三四医院外二科 第一作者：陈刚（1978- ）、男、浙江省德清县、医师、硕士、研究方向脊柱外科、037964133651jobzhang606@通讯作者：张松涛（1966-）、男、河南省洛阳市、副主任医师、学士、研究方向脊柱外科 HYPERLINK mailto:zhangsongtao@ zhangsongtao@洛阳市471000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月至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。AbstractObjective：The aim of this study is 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 fractures. Methods：Forty patients were included from January 2007 until January 2010. Patients with osteoporotic fractures ( 6 weeks) 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-month follow-up was comparable in the 2 groups (P0.05), intergroup difference was signi?cant (P0.05). In the PVP group, patients recovered soon. There was no signi?cant 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 fracture in the PVP group and non in the conservative group. Conclusion：The majority of patients with acute or subacute painful osteoporotic compression fractu