Twelve-Months Follow-up in Forty-Nine Patients With Acute/Semiacute Osteoporotic Vertebral Fractures Treated Conservatively or With Percutaneous Vertebroplasty A Clinical Randomized Study
Twelve-Months Follow-up in Forty-Nine Patients With Acute/Semiacute Osteoporotic Vertebral Fractures Treated Conservatively or With Percutaneous Vertebroplasty A Clinical Randomized Study
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DOI：
10.1097/brs.0b013e3181b71bd1
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发表时间：
2010-03-01
期刊：
影响因子：
3
通讯作者：
Lauritsen, Jens M.
中科院分区：
文献类型：
--
作者：
Rousing, Rikke;Hansen, Karina L.;Lauritsen, Jens M.
研究设计。临床随机研究。目标。对于急性或亚急性骨质疏松性椎体骨折的患者，经皮椎体成形术在疼痛、生理和精神结果方面与保守治疗进行了比较。评估与治疗节段相邻的椎体骨折的风险。关于PVP治疗急性骨质疏松性椎体骨折的益处还存在一些分歧，但PVP与保守治疗相比的长期临床结果尚未在随机研究中进行评估。这项研究的3个月的随访先前已经发表，我们在这里报告完成的12个月的分析。从2001年1月到2008年1月，纳入了大约50名患者(41名女性)。8周龄以下的椎体骨折患者被随机分为PVP组和保守治疗组。疼痛评分采用视觉模拟评分。通过有效的问卷和测试来评估身体和精神结果。在纳入时、3个月和12个月后进行测试、问卷调查和平片。PVP组术前疼痛评分7.9分，术后疼痛评分2.0分。在3个月和12个月的随访中，两组之间关于疼痛的差异没有差异。出院后1个月的腰背痛补充评估显示，PVP组的VAS评分明显低于保守组。在研究期间，PVP组有2个相邻骨折，保守组没有相邻骨折。PVP对一些急性/亚急性疼痛的骨质疏松性椎体骨折患者是一种很好的治疗方法，但大多数骨折在8-12周的保守治疗后会愈合，随后疼痛会减轻。新骨折的风险需要进一步研究。
Study Design. Clinical randomized study. Objective. Percutaneous vertebroplasty is compared to conservative treatment in patients with acute or subacute osteoporotic vertebral fractures with respect to pain, physical and mental outcomes. The risk of vertebral fractures adjacent to treated levels is assessed.Summary of Background Data. There are some disagreements of the benefits of PVP for the treatment of acute osteoporotic vertebral fractures, but the long-term clinical outcome of PVP compared to conservative treatment has not been evaluated in a randomized study.Methods. The 3-months follow-up of this study has been published previously, and here we report the completed 12-months analysis. About 50 patients (41 females) were included from January 2001 until January 2008. Patients with vertebral fractures less than 8 weeks old were included and randomized to either PVP or conservative treatment. Pain was assessed with a visual analogue scale. Physical and mental outcomes were assessed by validated questionnaires and tests. Tests, questionnaires, and plain radiographs were performed at the inclusion and after 3 and 12 months.Results. Pain score before and after the operation in the PVP group was 7.9 and 2.0, respectively. There was no difference between the groups concerning pain at the 3- and 12-months follow-up. Supplementary assessment of back pain 1 month after discharge from hospital showed a significant lower VAS score in the PVP group over the conservative group. In the study period, 2 adjacent fractures in the PVP group and no adjacent fractures in the conservative group were registered.Conclusion. PVP is a good treatment for some patients with acute/subacute painful osteoporotic vertebral fractures, but the majority of fractures will heal after 8 to 12 weeks of conservative treatment with subsequent decline in pain. The risk of new fractures needs further research.