摘要
目的 探讨老年急性椎体压缩骨折接受椎体成形术后矢状面脊柱排列的短期变化及其与Batherl指数变化的关系.方法 选择2020年1月至2021年12月在该院接受PVP治疗的单节段OVCF患者作为研究对象,观察患者术前、术后矢状垂直轴(SVA)、T1骨盆角(TPA)、脊柱骶骨角(SSA)、腰椎前凸角(LL)、胸椎后凸角(TK),术前、术后2周、术后6周、术后12周时的疼痛视觉模拟评分(VAS)、改良Batherl指数(MBI)及其子项目床椅转移(MBI8,15分)、平地行走(MBI9,15分)、上下楼梯(MBI10,10分)的变化;控制混杂变量后,观察ΔSVA、ΔTPA、ΔSSA、ΔLL、ΔTK(Δ表示手术前后的差值)与MBI总分、MBI8、MBI9、MBI10的相关性.结果 术后患者SVA、TPA、TK较术前显著降低(P＜0.05),术后患者的SSA、LL与术前相比,差异无统计学意义(P＞0.05).术前、术后2周、术后6周、术后12周时,患者MBI(总分、MBI8、MBI9、MBI10)逐渐升高、VAS均呈逐渐降低趋势(P＜0.05).多元线性回归结果显示,ΔMBI总分与ΔSVA呈负相关,与ΔSSA、ΔTPA、ΔLL和ΔTK均不存在相关性(P＞0.05);ΔMBI8、ΔMBI9 与 ΔSVA、ΔSSA、ΔTPA、ΔLL、ΔTK 均不存在相关性(P＞0.05);ΔMBI10 与 ΔSVA 存在显著负相关(P＜0.05),与ΔSSA、ΔTPA、ΔLL、ΔTK均不存在相关性(P＞0.05).结论 急性OVCF患者PVP术前和术后SVA值与患者术后12周时MBI总分和上下楼梯功能相关.
Abstract
Objective To investigate the short-term changes of sagittal spinal alignment after vertebroplasty in elderly patients with acute vertebral compression fractures and its relationship with Bathell index.Methods Single segment OVCF patients who received PVP treatment in our hospital from January 2020 to December 2021 were selected as study subjects.The sagittal vertical axis(SVA),T1 pelvic angle(TPA),spinal sacral angle(SSA),lumbar lordosis(LL)and thoracic kyphosis(TK)were observed before and after surgery.The changes of visual analog pain score(VAS),modified Bathell index(MBI)and its sub items bed chair transfer(MBI8,15 points),walking on the ground(MBI9,15 points),and going up and down stairs(MBI10,10 points)before,2 weeks after,6 weeks after,and 12 weeks after surgery.Results The SVA,TPA and TK of patients after operation were significantly lower than those before operation(P＜0.05),while the SSA and LL of patients after operation had no significant difference compared with those before operation(P＞0.05).At preoperative,postoperative 2 weeks,postoperative 6 weeks,and postoperative 12 weeks,the patient's MBI(total score,MBI8,MBI9,MBI10)gradually increased and VAS showed a gradually decreasing trend(P＜0.05).The results of multiple linear regression showed that the total score of ΔMBI was negatively correlated with ΔSVA,but not with ΔSSA,ΔTPA,ΔLL and ΔTK(P＞0.05).MBI8,MBI9 had no correlation with ΔSVA,ΔSSA,ΔTPA,ΔLL,ΔTK(P＞0.05).Conclusion The change of SVA in patients with acute OVCF before and after PVP is related to the total score of MBI.
维普
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