椎体成形术配合腰背肌功能锻炼治疗骨质疏松脆性骨折腰背痛的临床疗效研究

Clinical study on vertebroplasty combined with lumbar dorsal muscle functional exercise in the treatment of lumbago and back pain caused by fragility fracture of osteoporosis

目的 探讨椎体成形术配合腰背肌功能锻炼治疗骨质疏松脆性骨折的临床疗效。方法 将椎体成形术后的骨质疏松脆性骨折患者200例随机分成实验组与对照组,术后两组在常规抗骨质疏松治疗的基础上,实验组同时进行系统腰背肌功能锻炼。通过电话随访,评价其疗效。结果 200例患者均成功完成1年随访。实验组治疗后3个月[(18.43±2.66)]、6个月[(15.88±2.00)]及1年[(19.30±2.20)]的ODI指数优于对照组(P<0.05);治疗后3个月[(1.03±0.59)]、6个月[(1.20±0.45)]及1年[(1.43±0.54)]的VAS评分优于对照组(P<0.05)。随访1年内,对照组再发其他椎体急性压缩性骨折12例,占比12%;实验组再发其他椎体急性压缩性骨折3例,占比3%,差异有统计学意义(P<0.05)。结论 系统性腰背肌功能锻炼能明显改善椎体成形术后骨质疏松患者的腰背疼痛,并能降低患者再发脆性骨折的风险,改善患者生活质量。

Objective To explore the clinical effect of vertebroplasty combined with low back muscle functional exercise in the treatment of fragility fracture of osteoporosis.Methods 200 patients with fragility fracture of osteoporosis after vertebroplasty were randomly divided into experimental group and control group.After operation,two groups were given routine anti-osteoporosis treatment,on the basis the experimental group was given systemic lumbar dorsal muscle functional exercise.The efficacy was evaluated by telephone followup.Results All 200 patients were successfully followed up for 1 years.The Oswestry Disability Index in the experimental group at 3 months[(18.43±2.66)],6 months[(15.88±2.00)],and 1 year[(19.30±2.20)]after treatment were superior to those in the control group(P<0.05),and the VAS score in the experimental group at 3 months[(1.03±0.59)],6 months[(1.20±0.45)],and 1 year[(1.43±0.54)]after treatment were superior to those in the control group(P<0.05).The incidence of acute compression fracture recurrence of other vertebral body in the experimental group was lower than that in the control group(3%vs.12%)(P<0.05).Conclusion Systemic lumbar dorsal muscle functional exercise can significantly improve the low back pain of patients with osteoporosis after vertebroplasty,reduce the risk of recurrent fragility fracture,and improve the quality of life of patients,which is an important rehabilitation treatment method after vertebroplasty.