扶杖行走在pkp治疗骨质疏松性压缩性骨折后的作用

The effect of walking by stick on osteoporotic compression fracture patients after PKP treatment

目的评估pkp后扶杖行走在经皮椎体成型术治疗骨质疏松性压缩性骨折后的疗效。方法 2008年2月至2010年10月采用经皮后凸成形术治疗45例骨质疏松性压缩性骨折患者术前疼痛的部位、程度。手术后患者随机分为扶杖行走组(25例)和对照组(20例),将术后疼痛缓解时间、程度和活动能力评分分别采用视觉模拟法(VSA评分)和日常生活能力法(ADL评分)评分。随访时间3～24个月。平均12个月。结果 45例患者术后疼痛均明显减轻,而25例术后扶杖行走患者在术后(7±3.4)天恢复到伤前活动水平。对照组20例患者在术后(14±5.7)天恢复到伤前活动水平。两组差异有显著性(P<0.01)。在随访时间内扶杖组无相邻椎体的再压缩、无疼痛复发。对照组有7例(29%)疼痛复发、伴有相邻椎体的压缩。结论 pkp治疗骨质疏松性压缩性骨折疼痛的有效方法,而术后扶杖行走,能促进患者的恢复,能增加pkp术后疗效。

Objective To assess the effect of walking by stick on osteoporotic compression fracture patients after percutaneous kyphoplasty （PKP）. Methods From February 2008 to October 2010, 45 patients with osteoporotic compression fractures were treated with PKP. The patients were randomly divided into walking by stick group （25 cases） and control group （20 cases） after the surgery. The postoperative pain relief time, pain degree, and moving ability were evaluated using visual analog score （ VSA score） and activities of daily living （ADL） score. The patients were followed up for 3-24 months, 12 months in average. Results The postoperative pain were significantly reduced in all 45 patients. The moving ability was returned to preinjury level in 25 patients in walking by stick group 7 ±3.4 days after the surgery, and in 20 patients in the control group 14 ± 5.7 days after the surgery. The difference was significant between the two groups （P 〈 0.01 ）. During the follow-up time, no further adjacent vertebral compression fracture and pain recurrence occurred in walking by stick group. However in the control group, 7 patients （29%） had pain recurrence in associated with adjacent vertebral compression fracture. Conclusion PKP is an effective treatment for the pain after osteoporotic compression fractures. Walking by stick after the surgery can promote the recovery, and the curative effect of PKP.