老年骨质疏松性脊柱骨折的临床特点与治疗方法选择

Clinical feature and treatment selection for osteoporotic vertebral compression fractures

目的探讨老年骨质疏松性脊柱骨折的临床特点和治疗方法。方法对62例老年骨质疏松性脊柱骨折的临床表现和影像学特点进行分析,并根据不同特点采用保守治疗、手术治疗和两者结合的综合治疗;结果 62例骨折患者腰背疼痛的性质、部位和程度及影像学特点在骨折的不同阶段表现不同,所有患者分别于治疗前、治疗后1周和1月随访时进行疼痛强度的视觉评分:47例完全缓解,12例中度缓解,3例较治疗前无明显改变;活动能力评分:本组治疗后1分47例,2分15例。结论老年骨质疏松性脊柱骨折具有序贯性、疼痛多源性、诱因不明显、止痛效果差、治疗时间长等特点,应根据其临床特点和骨折的不同阶段,选择不同的治疗方法,大部分病人需综合治疗才能达到较为理想的效果。

Objective To explore the clinical feature and treatment for osteoporotic vertebral fractures. Methods Clinical manifestations and imaging characteristics of 62 patients with osteoporotic vertebral compression fractures were analyzed. Patients were treated either with conservative therapy, or surgery, or combinative treatment according to different characteristics. Results The properties, location, extent of low back pain, and imaging characteristics of those 62 cases were different at different stages of the fracture. VAS was performed to all patients to evaluate the pain before treatment, 1-week after treatment, and 1-month follow-up. Complete relieve was achieved in 47 patients, moderate relieve in 12 patients, and no significant change in 3 cases. The mobility scoring showed that 47 patients obtained 1 score and 15 patients obtained 2 scores. Conclusion Osteoporotic vertebral fractures in the elderly is characterized with sequential fractures, multi-source pain, no obvious incentive, poor analgesic effect, and long time for treatment. Treatment methods should be selected based on the clinical features and different stages of fractures. Most patients need combination therapy to achieve the ideal effect.