微创手术治疗骨质疏松性椎体骨折的长期随访效果

The difference between Minimally invasive and conservative treatment of osteoporotic vertebral fracture long-term follow-up

目的比较经皮穿刺术与保守治疗对老年骨质疏松性椎体骨折患者的长期随访效果。方法采用电话随访的方式,回顾性分析2016年1月~2018年6月本科收治的210例老年重度骨质疏松性椎体骨折患者的临床资料,其中行经皮穿刺术93例,保守治疗117例。随访时间为出院后3~24个月,比较两组患者再骨折发生率、疼痛度、肢体活动能力及门诊随访情况。结果手术组再骨折3例(4.7%),保守治疗组再骨折10例(13.0%),差异无统计学意义(P>0.05);手术治疗组疼痛评分为(0.83±1.279)分,保守治疗组疼痛评分为(3.22±0.766)分,两组比较差异有统计学意义(P<0.05);手术组规律门诊随访15人(23.4%),保守治疗组规律门诊随访40人(52.0%),差异有统计学意义(P<0.05);两组患者肢体活动能力比较,差异无统计学意义(P>0.05)。结论经皮穿刺术治疗老年骨质疏松性椎体骨折患者,患者的疼痛评分和再骨折发生率低于行保守治疗的患者,患者的门诊随访率高于行保守治疗的患者,显示了微创手术的长期随访效果较好,值得在临床推广应用。

Objective Comparison the pain score,outpatient follow-up rate,refracture rate and the ability of physical activity,two years either after the percutaneous puncture technique or conservative treatment,in order to serve as a guidance in practice.Methods 210 patients with serious Osteoporotic fracture were investigated by telephone call.Among these 210 cases,93 cases were subjected mini-invasive surgical operation while the 117 cases were treated conservatively,between 2016.01-2018.06.The refracture rate,the pain score,the ability of physical activity and out-patient follow-up were compared among 3-24months after hospital discharge.Results 3(4.7%)cases suffered refracture in the mini-invasive surgical operation group,while 10(13.0%)cases in conservative group,the difference was not statistically significant(P>0.05).The pain score in the surgical group was(0.83±1.279),and the other was(3.22±0.766).Through t-test,there were significant differences(P<0.05).15(23.4%)patients regularly visit outpatient department in the surgical group while in conservative group,the data is 40(52.0%),the difference was not statistically significant(P<0.05).Conclusions Within in two years,the pain score is significant different,while the refracture rate,the outpatient follow-up rate and the ability of physical activity have no statistical significance.Whatever longer time and richer follow-up form need more research and to be insisted.