Management of acute osteoporotic vertebral fractures: A nonrandomized trial comparing percutaneous vertebroplasty with conservative therapy
Management of acute osteoporotic vertebral fractures: A nonrandomized trial comparing percutaneous vertebroplasty with conservative therapy
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DOI：
10.1016/s0002-9343(02)01524-3
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发表时间：
2003-03-01
影响因子：
5.9
通讯作者：
Clark, WA
中科院分区：
文献类型：
--
作者：
Diamond, TH;Champion, B;Clark, WA
目得：我们试图确定是否经皮椎体成形术，其中包括注射水泥，以稳定骨折的椎体可能是一种有效的治疗vertebralfracture.METHODS：我们纳入了79个连续的椎体成形术患者（24名男性和55名女性，年龄51至93岁），急性椎体骨折。在基线时测量临床特征和骨密度。疼痛评分（0 ~ 25分）和功能水平（0 ~ 20分）分别记录在就诊时、治疗后24小时、6周和6 ~ 12个月。结果：55例（70%）患者接受经皮椎体成形术治疗，24例（30%）仅接受保守治疗。平均随访215天（范围：57 - 399天）。两组的基线临床特征、骨密度测定和骨折数据相似。椎体成形术后24小时，疼痛评分降低了53（从19到9; P = 0.0001）和身体功能改善29%（14至18岁; P = 0.0001），而在保守治疗的患者中，疼痛评分和身体功能在24小时内保持不变（与经皮椎体成形术后的变化相比，均P = 0.0001）。13名接受经皮椎体成形术治疗的患者（24%）能够在24小时后停止所有镇痛（P = 0.0001，而保守治疗的24名患者中无一人）。6周和6至12个月的临床结果相似，在两组。结论：当与保守治疗相比，经皮椎体成形术的结果在迅速缓解疼痛和快速康复。在经验丰富的医生手中，这是一种治疗急性椎体压缩性骨折的安全有效的方法。(C)2003年，Excerpta Medica Inc.
PURPOSE: We sought to determine whether percutaneous vertebroplasty-which involves the injection of cement to stabilize a fractured vertebral body may be an effective treatment for vertebral fracture.METHODS: We enrolled 79 consecutive osteoporotic patients (24 men and 55 women; ages 51 to 93 years) presenting with acute vertebral fractures. Clinical characteristics and bone densitometry were measured at baseline. Pain scores (on a 0 to 25 scale) and levels of function (on a 0 to 20 scale) were recorded on presentation, at 24 hours, at 6 weeks, and 6 to 12 months after therapy.RESULTS: Fifty-five patients (70%) were treated by percuta- neous vertebroplasty and 24 (30%) were treated by conservative therapy alone. They were followed for a mean of 215 days (range, 57 to 399 days). The baseline clinical characteristics, bone densitometry, and fracture data were similar in the two groups. Twenty-four hours after vertebroplasty, there was a 53% reduction in pain scores (from 19 to 9; P = 0.0001) and a 29% improvement in physical functioning (from 14 to 18; P = 0.0001), whereas pain scores and physical functioning remained unchanged at 24 hours in the patients treated conservatively (both P = 0.0001 compared with the changes after percutaneous vertebroplasty). Thirteen patients (24%) treated by percutaneous vertebroplasty were able to cease all analgesia after 24 hours (P = 0.0001 compared with none of the 24 patients treated conservatively). Clinical outcomes at 6 weeks and 6 to 12 months were similar, in both groups.CONCLUSION: When compared with conservative therapy, percutaneous vertebroplasty results in prompt pain relief and rapid rehabilitation. In experienced hands, it is a safe and effective procedure for treating acute osteoporotic vertebral compression fractures. (C) 2003 by Excerpta Medica Inc.