骨质疏松性椎体压缩骨折椎体强化术后康复治疗指南(2022版)  

Guideline for postoperative rehabilitation treatment following vertebral augmentation for osteoporotic vertebral compression fracture(version 2022)

作　　者：许正伟[1] 郝定均[1] 程黎明[2] 贺宝荣[1] 陈伯华[3] 陈晨 陈飞[5] 陈建 陈其昕[7] 杜良杰[8] 范顺武[9] 方忠[10] 冯世庆[11] 高延征[12] 关海山[13] 官众[14] 江华[15] 姜为民[16] 蒋电明 蒋军[18] 蒋阅[19] 贺利军 贺园 李波[21] 李涛[22] 李建军[8] 李喜功[23] 梁益建[24] 林斌 刘斌 刘波[27] 刘勇[28] 刘志斌[29] 卢旭华 马超[31] 钱列[32] 全仁夫[33] 桑宏勋 申海波[35] 舒均[36] 孙宏慧 孙天胜 谭军[38] 唐明星[39] 陶笙 滕红林[41] 田耘[42] 田纪伟 王强[44] 王新伟 吴建煌[39] 谢沛根[45] 许卫红[46] 颜滨[47] 杨勇[48] 殷国勇[49] 于晓兵[50] 曾玉红[1] 张国庆[3] 张晓勃[1] 赵杰[51] 朱悦[52] Xu Zhengwei;Hao Dingjun;Cheng Liming;He Baorong;Chen Bohua;Chen Chen;Che Fei;Chen Jian;Chen Qixin;Du Liangjie;Fan Shunwu;Fang Zhong;Feng Shiqing;Gao Yanzheng;Guan Haishan;Guan Zhong;Jiang Hua;Jiang Weimin;Jiang Dianming;Jiang Jun;Jiang Yue;He Lijun;He Yuan;Li Bo;Li Tao;Li Jianjun;Li Xigong;Liang Yijian;Lin Bin;Liu Bin;Liu Bo;Liu Yong;Liu Zhibin;Lu Xuhua;Ma Chao;Qian Lie;Quan Renfu;Sang Hongxun;Shen Haibo;Shu Jun;Sun Honghui;Sun Tiansheng;Tan Jun;Tang Mingxing;Tao Sheng;Teng Honglin;Tian Yun;Tian Jiwei;Wang Qiang;Wang Xinwei;Wu Jianhuang;Xie Peigen;Xu Weihong;Yan Bin;Yang Yong;Yin Guoyong;Yu Xiaobing;Zeng Yuhong;Zhang Guoqing;Zhang Xiaobo;Zhao Jie;Zhu Yue(Honghui Hospital,Xi′an Jiaotong University,Xi′an 710054,China;Tongji Hospital of Tongji University,Shanghai 20065,China;Affiliated Hospital of Qingdao University,Qingdao 266003,China;Shanxi Bethune Hospital,Taiyuan 030032,China;Second Xiangya Hospital of Central South University,Changsha 410012,China;Yinchuan Guolong Hospital,Yinchuan 750003,China;Second Affiliated Hospital of Zhejiang University School of Medicine,Hangzhou 310009,China;China Rehabilitation Research Center,Beijing 100068,China;Sir Run Run Shaw Hospital,Zhejiang University School of Medicine,Hangzhou 310016,China;Tongji Hospital,Tongji Medical College of Huazhong University of Science and Technology,Wuhan 430030,China;Tianjin Medical University General Hospital,Tianjin 300052,China;Henan Provincial People′s Hospital,Zhengzhou 450003,China;Second Hospital of Shanxi Medical University,Taiyuan 030031,China;Affiliated Hospital of Qinghai University,Xining 810001,China;First Affiliated Hospital of Guangxi Medical University,Nanning 5300211,China;First Affiliated Hospital of Soochow University,Suzhou 215006,China;Third Affiliated Hospital of Chongqing Medical University,Chongqing 401120,China;Nanjing Drum Tower Hospital,Nanjing 210008,China;People′s Hospital of Liaoning Province,Shenyang 110067,China;Xi′an Fifth Hospital,Xi′an 710082,China;Guizhou Provincial People′s Hospital,Guiyang 55049

机构地区：[1]西安交通大学附属红会医院,西安710054 [2]同济大学附属同济医院,上海200065 [3]青岛大学附属医院,青岛266000 [4]山西白求恩医院,太原030032 [5]中南大学湘雅二医院,长沙410012 [6]银川国龙医院,银川750003 [7]浙江大学医学院附属第二医院,杭州310003 [8]中国康复研究中心,北京100068 [9]浙江大学医学院邵逸夫医院,杭州310016 [10]华中科技大学同济医学院附属同济医院,武汉430030 [11]天津医科大学总医院,天津300052 [12]河南省人民医院,郑州450003 [13]山西医科大学第二医院,太原030031 [14]青海大学附属医院,西宁810001 [15]广西医科大学第一附属医院,南宁530021 [16]苏州大学附属第一医院,苏州215006 [17]重庆医科大学附属第三医院,重庆401120 [18]南京鼓楼医院,南京210008 [19]辽宁省人民医院,沈阳110067 [20]西安市第五人民医院,西安710082 [21]贵州省人民医院,贵阳550499 [22]四川大学华西医院,成都610044 [23]浙江大学医学院附属第一医院,杭州310003 [24]成都市第三人民医院,成都610014 [25]联勤保障部队第九○九医院,漳州363099 [26]内蒙古医科大学附属医院,呼和浩特010107 [27]北京积水潭医院,北京100035 [28]西藏自治区人民医院,拉萨850010 [29]延安大学附属医院,延安716099 [30]海军军医大学第二附属医院,上海200003 [31]徐州市中心医院,徐州221009 [32]上海交通大学医学院附属仁济医院,上海200120 [33]浙江中医药大学附属江南医院(萧山中医院),杭州311201 [34]南方医科大学深圳医院,深圳518101 [35]北京市顺义区医院,北京101312 [36]昆明医科大学第二附属医院,昆明650106 [37]中国人民解放军总医院第七医学中心,北京100026 [38]同济大学附属东方医院,上海200120 [39]中南大学湘雅医院,长沙410008 [40]中国人民解放军总医院海南分院,三亚572013 [41]温州医科大学附属第一医院,温州325015 [42]北京大学第三医院,北京100191 [43]南京江�

出　　处：《中华创伤杂志》2022年第11期961-972,F0003,共13页Chinese Journal of Trauma

摘　　要：骨质疏松性椎体压缩骨折(OVCF)可导致患者腰背部疼痛,严重者可伴发侧后凸畸形、神经功能损伤等并发症,影响患者日常活动能力和生活质量。椎体强化术是治疗OVCF的有效方法,但椎体强化术并不能纠正骨代谢失衡,无法改善骨质疏松状态,术后常发生腰背痛、脊柱活动受限及椎体再骨折等并发症。术后系统、规范的康复治疗可提高疗效和骨质疏松症的治疗效果、降低椎体再骨折发生风险、增加患者依从性、提高患者生存质量。但目前缺乏针对OVCF椎体强化术后康复治疗的相关临床治疗指南,导致治疗方法混杂、治疗效果参差不齐。为了规范OVCF椎体强化术后的康复治疗,中国医师协会骨科医师分会脊柱创伤学组牵头并组织相关专家,借鉴美国骨科医师协会(AAOS)公布的相关临床指南,遵循科学性、实用性和先进性原则,制订了《骨质疏松性椎体压缩骨折椎体强化术后康复治疗指南(2022版)》,针对OVCF患者椎体强化术后康复治疗的10个相关重要问题提出基于循证医学证据的建议。Osteoporotic vertebral compression fracture(OVCF)can lead to lower back pain and may be even accompanied by scoliosis,neurological dysfunction and other complications,which will affect the daily activities and life quality of patients.Vertebral augmentation is an effective treatment method for OVCF,but it cannot correct unbalance of bone metabolism or improve the osteoporotic status,causing complications like lower back pain,limited spinal activities and vertebral refracture.The post-operative systematic and standardized rehabilitation treatments can improve curative effect and therapeutic efficacy of anti-osteoporosis,reduce risk of vertebral refracture,increase patient compliance and improve quality of life.Since there still lack relevant clinical treatment guidelines for postoperative rehabilitation treatments following vertebral augmentation for OVCF,the current treatments are varied with uneven therapeutic effect.In order to standardize the postoperative rehabilitation treatment,the Spine Trauma Group of the Orthopedic Branch of Chinese Medical Doctor Association organized relevant experts to refer to relevant literature and develop the"Guideline for postoperative rehabilitation treatment following vertebral augmentation for osteoporotic vertebral compression fracture(2022 version)"based on the clinical guidelines published by the American Academy of Orthopedic Surgeons(AAOS)as well as on the principles of scientificity,practicality and advancement.The guideline provided evidence-based recommendations on 10 important issues related to postoperative rehabilitation treatments of OVCF.

关 键 词：骨质疏松 脊柱骨折 骨折 压缩性 康复 指南 椎体强化术 

分 类 号：R687.3[医药卫生—骨科学]