老年骨质疏松性椎体压缩性骨折部位和腰椎骨密度对下腰部疼痛的影响  

Research of the effect of bone mineral density and fracture site of the vertebrae on low back pain in elderly patients with osteoporotic vertebral compression fractures

作　　者：沈煜[1] 冯明利[1] 徐军[1] 张杰[1] 陈兵[1] 刘征宇[1] 安帅[1] 沈惠良[1] 张文博[2] 方秀统[3] 

机构地区：[1]首都医科大学宣武医院骨科,北京100053 [2]北京军区总医院肾内科 [3]首都医科大学世纪坛医院骨科

出　　处：《中华医学杂志》2016年第23期1818-1820,共3页National Medical Journal of China

摘　　要：目的探讨老年骨质疏松椎体压缩性骨折部位和腰椎骨密度对下腰部疼痛的影响。方法回顾性分析2011年8月至2013年8月期间在首都医科大学宣武医院行椎体后凸成形术107例（118个骨折椎体）老年骨质疏松性脊柱压缩骨折患者随访2年以上（平均2．5年）的完整资料，疼痛视觉模拟评分（VAS）分析椎体后凸成形术后下腰痛的发生率，分析患者骨密度（BMD，双能量X线吸收测定法）、椎体压缩骨折部位及椎体骨折数量与下腰部疼痛的关系。结果18例（16．8％）患者椎体后凸成形术后出现下腰痛，随着腰椎骨密度平均T值[（-2．90±0．91）比（-4．87±0．52）]的下降，下腰部VAS疼痛指数[（3．12±0．91）比（4．03±1．08）]呈上升趋势（P〈0．05）；骨折部位越是临近下腰椎，下腰部疼痛发生的概率越高，疼痛程度越重。结论椎体后凸成形术后16．8％的患者会显现下腰部明显疼痛。腰椎骨密度和椎体骨折部位是导致下腰部疼痛发生的重要因素。Objective To investigate the effect of bone mineral density（BMD） and fracture site of the vertebrae on low back pain in elderly patients with osteoporotic vertebral compression fractures. Methods From August 2011 to August 2013, a total of 107 senile patients with osteoporotic vertebral compression fractures underwent percutaneous vertebroplasty were followed up fbr more than 2 （ average 2. 5 ） years in Department of orthopedics, Xuanwu Hospital, Capital Medical University. The incidence of low back pain after vertebroplasty were analyzed on visual analog scale （VAS）, and the relationship between BMD, vertebral fraeture site were investigated. Results A total of 18 cases （16. 8% ）after vertebroplasty have significant low back pain. Along with BMD decreased [ （ -2. 90 ±0. 91 ） vs （ -4. 87 ±0. 52） ] , the VAS of low back pain increasing, which showed statistical significance difference[ （ -3.12 ± 0. 91 ） vs （4.03±1.08 ） , P 〈 0. 05 ] . The site of vertebral fracture was lower, the VAS was higher. Conclusions About 16. 8% patients show obvious low back pain after vertebroplasty. BMD and Vertebral fracture site were important factors of low back pain in elderly patients with osteoporotic vertebral compression fractures after vertebroplasty.

关 键 词：脊柱后凸 骨质疏松 脊柱骨折 骨密度 腰痛 老年人 

分 类 号：R687.3[医药卫生—骨科学] R580[医药卫生—外科学]