胸腰段骨质疏松性骨折严重程度评分评估及临床应用

Score assessment system of severity of thoracolumbar osteoporotic fracture and its clinical application

中文关键词:  胸腰段骨质疏松性骨折  严重程度  评分评估  临床应用

英文关键词:Thoracolumbar osteoporotic fracture  Severity  Score assessment  Clinical application

中文摘要:

  【摘要】 目的：尝试对胸腰段骨质疏松性骨折严重程度提出一种新的评估方法，探讨将其用于指导临床治疗的可行性。方法：选取381例骨质疏松性胸腰段骨折患者，结合伤椎形态学改变、伤椎MRI信号改变、骨密度和临床表现（疼痛）四个方面进行评分，根据不同的总分值（T，0～8分）对骨折的严重程度进行评估，并采用相应的治疗方式，根据VAS评分及ODI评分随访观察治疗效果。结果：所有患者均获得6～30个月随访，平均20.1个月。本组中T＜4分者91例，行保守治疗，VAS评分由8.0±1.7分恢复至2.0±1.3分；ODI评分由69.5±2.8分恢复至38.1±1.5分。T=4分者132例，保守治疗57例，PKP/PVP手术治疗75例，VAS评分由8.2±1.4分恢复至1.9±1.2分；ODI评分由71.5±3.7分恢复至36.2±2.5分。T≥5分者158例，均行手术治疗，VAS评分从术前平均8.1±1.6分恢复至1.8±1.3分；ODI由术前的70.5±2.6分恢复至术后的39.2±1.7分。结论：胸腰段骨质疏松性骨折严重程度评分评估系统可以用于指导临床治疗，但其有效性尚需进一步检验。

英文摘要:

  【Abstract】 Objective: To put forward a new score system for assessment of thoracolumbar osteoporotic fracture in search of guidance for treatment. Methods: 381 patients with thoracolumbar osteoporotic fracture were assessed based on the morphological change, MRI, bone mineral density, and pain,. Corresponding treatment method was selected according to the scores(T, 0-8 points). Results: Follow up was obtained for all patients with average time of 20.1 months(ranged from 6 to 30 months). Patients with T score less than 4 pionts (91/381) underwent conservative treatment. As a result the VAS score decreased from 8.0±1.7 to 2.0±1.3 and the ODI score also reduced from 69.5±2.8 to 38.1±1.5. In 132 cases, for whom T=4, 57 received conservative treatment while the rest 75 underwent PKP/PVP. The VAS score decreased from 8.2±1.4 to 1.9±1.2; the ODI score decreased from 71.5±3.7 to 36.2±2.5. In the group where T≥5, all 158 cases undergone surgery with a restoration of both VAS and ODI score from 8.1±1.6 to 1.8±1.3 and from 70.5±2.6 to 39.2±1.7 respectively. Conclusions: The proposed assessment system based on severity of thoracolumbar osteoporotic fracture can be used to guide clinical treatment, though efficacy needs further inspection.