首页|胸腰椎骨质疏松性椎体压缩性骨折对老年脊柱平衡及腰背部功能的影响

胸腰椎骨质疏松性椎体压缩性骨折对老年脊柱平衡及腰背部功能的影响

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目的 分析保守治疗胸腰椎骨质疏松性椎体压缩性骨折(OVCF)对老年患者脊柱平衡及腰背部功能的影响.方法 回顾性分析147例保守治疗的胸腰椎OVCF患者的影像学资料(OVCF组).将147例胸腰椎OVCF患者分为胸椎骨折组(T6~T10骨折,A组,38例)、胸腰段骨折组(T11~L2骨折,B组,59例)、腰椎骨折组(L3~L5骨折,C组,50例).选择44例无胸腰椎骨折的退行性脊柱疾病患者作为对照组.收集191例患者骨密度值,在脊柱全长片上测量矢状位及冠状位参数:包括胸椎后凸角(TK)、胸腰后凸角(TLK)、腰椎前凸角(LL)、骨盆入射角(PI)、骨盆倾斜角(PT)、骶骨倾斜角(SS)、C7铅垂线与骶骨中垂线距离(C-Align).通过问卷调查电话回访VAS疼痛评分和Oswestry功能障碍指数(ODI)评分.结果 OVCF组与对照组TK、TLK、LL、C-Align、VAS疼痛评分及ODI评分均有统计学差异(P<0.05),而PI、PT和SS相仿(P>0.05).OVCF组内三组间TK、TLK、C-Align、VAS疼痛评分及ODI评分有统计学差异(P<0.05),而三组间LL、PI、PT和SS相仿(P>0.05).结论 胸腰椎OVCF能够导致老年患者脊柱失衡,从而加重腰背部疼痛和腰背部功能受限.
Effects of thoracolumbar osteoporotic vertebral compression fracture on spinal balance and lumbar back function in the elderly patients
Objective To analyze the effects of conservative treatment of osteoporotic vertebral compression fracture(OVCF)on spinal balance and lumbar back function in elderly patients.Methods The imaging data of 147 patients with thoracolumbar vertebral OVCF underwent conservative treatment were retrospective analyzed in OVCF group.The patients were divided into three groups of A(with T6-T10 fractures,38 cases),B(with T11-L2 fractures,59 cases)and C(with L3-L5 fractures,50 cases).Forty-four patients with non fractured degenerative spinal diseases were taken as the control group.The bone density values of 191 patients were collected.The sagittal and coronal parameters on a full length spine X-ray were measured,which included thoracic kyphosis(TK),thoracolumbar kyphosis(TLK),lumbar lordosis(LL),pelvic incidence angle(PI),pelvic tilt angle(PT),sacral slope angle(SS),the distance between the C7 plumb line and the midline of the sacrum(C-Align).The VAS painscore and Oswestry disability index(ODI)score were recorded by questionnaire survey and telephone follow-up.Results There were statistically significant differences in TK,TLK,LL,C-Align,VAS pain score and ODI scores between the OVCF group and the control group(P<0.05),but there were no significant differences in PI,PT,and SS between the two group(P>0.05).There were statistically significant differences in TK,TLK,C-Align,VAS pain score and ODI score among the three groups of A,B and C(P<0.05),while there were no statistically significant differences in LL,PI,PT and SS among the three groups in OVCF group(P>0.05).Conclusion Thoracolumbar OVCF can lead to spinal imbalance in elderly patients,which thereby exacerbating the lumbar back pain and reducing lumbar back function.

OsteoporosisVertebral compression fracturelumbar back functionSpinal imbalance

钱进、朱元宸、胡翰峰、史金辉

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215000 江苏,苏州大学附属第一医院骨科

骨质疏松 椎体压缩性骨折 腰背部功能 脊柱失衡

2024

江苏医药
江苏省人民医院(南京医科大学第一附属医院)

江苏医药

影响因子:0.707
ISSN:0253-3685
年,卷(期):2024.50(9)