抑郁对椎体后凸成形术治疗骨质疏松性椎体压缩骨折的疗效影响

The Influence of Depression on the Efficacy of Kyphoplasty for Osteoporotic Vertebral Compression Fractures

目的评估抑郁对椎体后凸成形术治疗骨质疏松性椎体压缩骨折的疗效影响.方法回顾性分析同一治疗组在2016年8月-2018年12月采用椎体后凸成形术治疗骨质疏松性椎体压缩骨折患者128例.术前采用抑郁自评量表评估分为抑郁组(n=18)和非抑郁组(n=110).术前、术后第2天及末次随访采用视觉疼痛模拟评分(visual analogue scale,VAS)、Oswestry功能障碍指数(Oswestry disability index,ODI)评估患者疼痛及生活质量.分别比较两组术后第2天与术前疼痛及生活质量改善情况;并比较两组术后第2天、末次随访抑郁程度、疼痛及生活质量.结果所有患者均顺利实施手术,术后无严重并发症发生.两组患者术后第2天与术前VAS、ODI评分比较均有显著改善(P<0.05);术后第2天两组抑郁评分、VAS、ODI评分比较差异具有统计学意义(P<0.05),而在末次随访差异无统计学意义(P>0.05).结论抑郁影响椎体后凸成形术治疗骨质疏松性椎体压缩骨折患者的疼痛及生活质量的改善,术后抑郁的干预是十分重要的.

Objective To assess whether depression influences the clinical effect of osteoporotic vertebral compression fractures treated by kyphoplasty.Methods 128 patients with osteoporotic vertebral compression fractures were treated by kyphoplasty from August 2016 to December 2018.All patients were divided into two groups according to self-rating depression scale before kyphoplasty:depression group(n=18)and without depression group(n=110).Visual analogue scale(VAS)and Oswestry disability index(ODI)were used to evaluate pain and functional activity before surgery,at 1 day after surgery and at the final follow-up.The VAS and ODI of the two groups were compared before and at 1 day after surgery.The self-rating depression scale,VAS and ODI were compared between two groups at 1 day after surgery and at the final follow-up.Results All of the patients tolerated the procedures well.There were significant improvements in both groups(P<0.05)in the mean VAS scores and ODI scores at 1 day after surgery.There were no differences of self-rating depression scale,VAS and ODI between both groups at 1 day after surgery.However,there were no differences of self-rating depression scale,VAS and ODI between both groups at the final follow-up.Conclusion Depression affected the improvement of pain and functional activity of osteoporotic vertebral compression fractures by kyphoplasty.It is very important to intervene depression postoperatively.