术后腰背肌功能训练在经皮椎体成形术治疗骨质疏松性椎体骨折中的作用

Postoperatively back muscle exercise after percutaneous vertebroplasty for spinal osteoporotic compression fracture

目的:评价术后腰背肌功能训练在经皮椎体成形术治疗骨质疏松性椎体压缩性骨折中的作用。方法:60例骨质疏松性椎体压缩性骨折患者随机分为A、B两组,每组30例,均行经皮椎体成形术治疗,A组术后仅进行抗骨质疏松治疗;B组术后进行抗骨质疏松联合系统性腰背肌训练。记录两组患者术前、术后第3天、1个月、6个月及1年的视觉模拟评分(visual analogue scale,VAS)和Oswestry功能障碍指数(Oswestry Disability Index,ODI),配对资料的t检验对组内数据行统计学分析,两组独立样本的t检验对组间数据行统计学分析。结果:48例患者得到1年以上随访,A组23例,B组25例。VAS评分及ODI指数均显示两组患者治疗后疼痛均有明显缓解,术前分别与术后3天、1个月、6个月及1年相比差异均有显著性(P<0.05);A组VAS评分与B组相比较,术后1年数据差异有显著性(P<0.05)。A组ODI指数与B组相比较,术后6个月及1年数据差异有显著性(P<0.05)。结论:术后系统性腰背肌训练能够提高经皮椎体成形术治疗骨质疏松性胸腰段压缩性骨折的中、长期临床疗效。

Objective： To analysis the effects of postoperatively back muscle exercise after percutaneous vertebroplasty for spinal osteoporotic compression fracture. Method： Sixty cases with percutaneous vertebroplasty for osteoporotic compression fracture were divided into 2 groups. Postoperatively, Group A was treated by anti-osteoporotic medicine alone; group B was treated by antiosteoporotic medicine combined with systematic back muscle exercise. Both visual analogue scale （VAS） and Oswestry Disability Index （ODI） were recorded pre-operatively and 3d, 1 month, 6 months and 1 year post- operatively. Result： Forty-eight patients were followed-up for more than 1 year, there were 23 patients in group A, and 25 patients in group B. The VAS and ODI scores showed that the patients＇ pain in both group A and B relived effectively, the differences between pre-and post-operation（Bd,1 month,6 months） were significant （P〈0.05）. The VAS showed there was significant difference between group A and B on I year follow-up （P〈0.05）. The ODI showed there were significant differences between group A and B on 6 months and 1 year follow-up （P〈0.05）. Conclusion： The systematic back muscle exercise postoperatively is benefit to mid-and long-term outcomes of percutaneous vertebroplasty for spinal osteoporotic compression fracture.