Clinical efficacy and quality of life in super-elderly patients with osteoporotic vertebral com-pression fractures after vertebral augmentation
To compare the clinical efficacy and quality of life(QoL)in super-elderly patients with osteopo-rotic vertebral compression fractures(OVCFs)managed by vertebral augmentation or conservative treatment,and to provide clinical data and reference for more reasonable management of OVCFs in elder patients.Methods This pro-spective study was conducted on 62 OVCF patients aged 85-98(mean 88.2)years and treated at the Affiliated Hos-pital of Southwest Medical University & Sichuan Provincial People's Deyang Hospital from Jan.2022 to Mar.2023 by vertebral augmentation or conservative treatment.There were 20 males and 42 females,who were divided into sur-gery group(vertebral augmentation,n=39)and non-surgery group(conservative treatment,n=23).The baseline da-ta and lower back pain by VAS before,1 week and 3 months after treatment and at last follow-up were recorded.The Odom criteria was used to evaluate the clinical efficacy of the two groups;while the QoL was evaluated by using the 36-item short-form survey(SF-36),including the physical component score(PCS),mental component score(MCS)and total score.Pearson or Spearman correlation analysis was used to analyze factors affecting the QoL.Re-sults All patients were followed up for 12-18(mean 14.2)months without loss of follow-up or death.The baseline data showed no significant difference between the two groups(P＞0.05).Two cases of complications were reported in the surgical group and 6 in the non-surgery group(P＜0.05).The excellent and good rate by Odom criteria was higher in the surgery group than in the non-surgery group at 1 week(97.4％vs.39.1％),3 months(92.3％vs.60.9％)and last follow-up(94.8％vs.86.9％).Compared with before treatment,the VAS at each follow-up time point and the PCS,MCS and total score of SF-36 at the last follow-up were significantly improved in both groups(all P＜0.05).Moreover,the surgery group revealed much lower VAS at each follow-up time point(1 week after treat-ment:3(3,4)vs.5(4,6);3 months after treatment:2(2,3)vs.3(3,4);last follow-up:2(1,2)vs.3(2,3),and better SF-36 outcomes at last follow-up(PCS 48.1±2.0 vs.28.7±1.7,MCS 57.8±1.9 vs.38.2±2.2),com-pared with the non-surgery group(all P＜0.05).Correlation analysis showed that age,number of fractured verte-brae,and VAS of the lower back before treatment were negatively correlated with SF-36 score at the last follow-up,while the T value of bone mineral density and PCS and MCS of SF-36 before treatment were positively correlated with SF-36 score.Conclusion Vertebral augmentation can quickly relieve pain,improve QoL and reduce complications in super-elderly OVCF patients.Age,bone status,number of fractured vertebrae,VAS after injury and QoL before treatment are important factors affecting the QoL of such patients.
Osteoporotic vertebral compression fracturesVertebral augmentationSuper-elderlyQuality of life
万方数据
维普
