目的分析经皮椎体成形术(PVP)对骨质疏松性胸腰椎Ⅰ度压缩性骨折患者影像参数、Oswestry功能障碍指数(ODI)及并发症的影响。方法选择2018年5月—2021年4月收治的骨质疏松性胸腰椎Ⅰ度压缩性骨折122例,按照治疗方式分为研究组74例和对照...目的分析经皮椎体成形术(PVP)对骨质疏松性胸腰椎Ⅰ度压缩性骨折患者影像参数、Oswestry功能障碍指数(ODI)及并发症的影响。方法选择2018年5月—2021年4月收治的骨质疏松性胸腰椎Ⅰ度压缩性骨折122例,按照治疗方式分为研究组74例和对照组48例。研究组给予PVP治疗,对照组给予经皮椎体后凸成形术治疗。比较2组手术相关指标、影像参数、椎体功能、疼痛程度及并发症发生情况。结果研究组手术时间、住院时间短于对照组,骨水泥量少于对照组(P<0.01)。与术前比较,2组术后椎体中部高度均上升、Cobb角均减小,且研究组椎体中部高度低于对照组(P<0.05,P<0.01)。与术前相比,2组术后ODI评分降低、日本骨科协会评估治疗分数评分升高(P<0.05)。2组术后视觉模拟评分法(VAS)评分均低于术前,且研究组术后1 d VAS评分低于对照组(P<0.05,P<0.01)。2组并发症发生率比较差异无统计学意义(P>0.05)。结论PVP治疗骨质疏松性胸腰椎Ⅰ度压缩性骨折效果确切,可有效缩短手术时间,促进术后恢复,改善椎体功能,且能早期缓解疼痛,安全性较高。展开更多
AIM:To investigate the correlation of facet joint osteoarthritis(FJOA) at lumbar levels L4/L5 and L5/S1 and the Oswestry Disability Index(ODI).METHODS:The study involved lumbar MRIs of 591 patients with a mean age of ...AIM:To investigate the correlation of facet joint osteoarthritis(FJOA) at lumbar levels L4/L5 and L5/S1 and the Oswestry Disability Index(ODI).METHODS:The study involved lumbar MRIs of 591 patients with a mean age of 47.3 years.The MRIs of the lumbar spine were performed on a 1.5 Tesla scanner(Magnetom Avanto,Siemens AG,Erlangen,Germany) using a dedicated receive only spine coil.After initial blinding,each dataset was evaluated by 2 board certified radiologist with more than 5 years experience in musculoskeletal imaging.In total 2364 facet joints were graded.Degenerative changes of the facet joints were evaluated according to the 4-point scale as proposed by Weishaupt et al Functional status was assessed using the ODI.The index is scored from 0 to 100 and interpreted as follows:0%-20%,minimaldisability; 20%-40%,moderate disability; 40%-60%,severe disability; 60%-80%,crippled; 80%-100%,patients are bedbound.Spearman’s coefficient of rank correlation was used for statistical analysis,with significance set at P 【 0.05.RESULTS:In total 2364 facet joints at lumbar levels L4/5 and L5/S1 were analysed in 591 individuals.FJOA was present in 97%(L4/L5) and 98%(L5/S1).At level L4/5(left/right) 17/15(2.9%/2.5%) were described as grade 0,146/147(24.7%/24.9%) as grade 1,290/302(49.1%/51.1%) as grade 2 and 138/127(23.4%/21.5%) as grade 3.At level L5/S1(left/right) 10/11(1.7%/1.9%) were described as grade 0,136/136(23.0%/23.0%) as grade 1,318/325(53.8%/55.0%) as grade 2 and 127/119(21.5%/20.1%) as grade 3.Regarding the ODI scores,patients’ disability had a minimum of 0% and a maximum of 91.11% with an arithmetic mean of 32.77% ± 17.02%.The majority of patients(48.39%) had moderate functional disability(21%-40%).There was no significant correlation between FJOA and ODI on both sides of lumbar level L4/5 and on the left side of lumbar level L5/S1.A weak positive correlation was evaluated between ODI and FJOA on the right side of lumbar level L5/S1.CONCLUSION:The missing correlation of FJOA and ODI confirms our clinical experience that imaging alone is an insufficient approach explaining low back pain.Clinical correlation is imperative for an adequate diagnostic advance in patients with low back pain.展开更多
文摘目的分析经皮椎体成形术(PVP)对骨质疏松性胸腰椎Ⅰ度压缩性骨折患者影像参数、Oswestry功能障碍指数(ODI)及并发症的影响。方法选择2018年5月—2021年4月收治的骨质疏松性胸腰椎Ⅰ度压缩性骨折122例,按照治疗方式分为研究组74例和对照组48例。研究组给予PVP治疗,对照组给予经皮椎体后凸成形术治疗。比较2组手术相关指标、影像参数、椎体功能、疼痛程度及并发症发生情况。结果研究组手术时间、住院时间短于对照组,骨水泥量少于对照组(P<0.01)。与术前比较,2组术后椎体中部高度均上升、Cobb角均减小,且研究组椎体中部高度低于对照组(P<0.05,P<0.01)。与术前相比,2组术后ODI评分降低、日本骨科协会评估治疗分数评分升高(P<0.05)。2组术后视觉模拟评分法(VAS)评分均低于术前,且研究组术后1 d VAS评分低于对照组(P<0.05,P<0.01)。2组并发症发生率比较差异无统计学意义(P>0.05)。结论PVP治疗骨质疏松性胸腰椎Ⅰ度压缩性骨折效果确切,可有效缩短手术时间,促进术后恢复,改善椎体功能,且能早期缓解疼痛,安全性较高。
文摘AIM:To investigate the correlation of facet joint osteoarthritis(FJOA) at lumbar levels L4/L5 and L5/S1 and the Oswestry Disability Index(ODI).METHODS:The study involved lumbar MRIs of 591 patients with a mean age of 47.3 years.The MRIs of the lumbar spine were performed on a 1.5 Tesla scanner(Magnetom Avanto,Siemens AG,Erlangen,Germany) using a dedicated receive only spine coil.After initial blinding,each dataset was evaluated by 2 board certified radiologist with more than 5 years experience in musculoskeletal imaging.In total 2364 facet joints were graded.Degenerative changes of the facet joints were evaluated according to the 4-point scale as proposed by Weishaupt et al Functional status was assessed using the ODI.The index is scored from 0 to 100 and interpreted as follows:0%-20%,minimaldisability; 20%-40%,moderate disability; 40%-60%,severe disability; 60%-80%,crippled; 80%-100%,patients are bedbound.Spearman’s coefficient of rank correlation was used for statistical analysis,with significance set at P 【 0.05.RESULTS:In total 2364 facet joints at lumbar levels L4/5 and L5/S1 were analysed in 591 individuals.FJOA was present in 97%(L4/L5) and 98%(L5/S1).At level L4/5(left/right) 17/15(2.9%/2.5%) were described as grade 0,146/147(24.7%/24.9%) as grade 1,290/302(49.1%/51.1%) as grade 2 and 138/127(23.4%/21.5%) as grade 3.At level L5/S1(left/right) 10/11(1.7%/1.9%) were described as grade 0,136/136(23.0%/23.0%) as grade 1,318/325(53.8%/55.0%) as grade 2 and 127/119(21.5%/20.1%) as grade 3.Regarding the ODI scores,patients’ disability had a minimum of 0% and a maximum of 91.11% with an arithmetic mean of 32.77% ± 17.02%.The majority of patients(48.39%) had moderate functional disability(21%-40%).There was no significant correlation between FJOA and ODI on both sides of lumbar level L4/5 and on the left side of lumbar level L5/S1.A weak positive correlation was evaluated between ODI and FJOA on the right side of lumbar level L5/S1.CONCLUSION:The missing correlation of FJOA and ODI confirms our clinical experience that imaging alone is an insufficient approach explaining low back pain.Clinical correlation is imperative for an adequate diagnostic advance in patients with low back pain.
