左歸丸聯(lián)合球囊擴張椎體成形術(shù)治療老年骨質(zhì)疏松性椎體壓縮骨折的臨床療效觀察

左歸丸聯(lián)合球囊擴張椎體成形術(shù)治療老年骨質(zhì)疏松性椎體壓縮骨折的臨床療效觀察摘要：目的：探討左歸丸聯(lián)合球囊擴張椎體成形術(shù)治療老年骨質(zhì)疏松性椎體壓縮骨折的臨床療效。方法：選取2020年1月至2021年12月在我院接受治療的老年骨質(zhì)疏松性椎體壓縮骨折患者100例，按照隨機數(shù)字表法分為觀察組和對照組各50例。對照組采用常規(guī)手術(shù)治療，觀察組采用左歸丸聯(lián)合球囊擴張椎體成形術(shù)治療。比較兩組在手術(shù)時間、出血量、術(shù)后感染、椎體恢復(fù)高度、椎體前緣垂直高度、骨折愈合時間、VAS評分、ODI評分等方面的差異。結(jié)果：觀察組和對照組手術(shù)時間、出血量無差異，觀察組術(shù)后感染、椎體恢復(fù)高度、椎體前緣垂直高度、骨折愈合時間、VAS評分、ODI評分均優(yōu)于對照組（P<0.05）。結(jié)論：左歸丸聯(lián)合球囊擴張椎體成形術(shù)治療老年骨質(zhì)疏松性椎體壓縮骨折具有安全可靠、恢復(fù)效果良好的療效。

關(guān)鍵詞：左歸丸；球囊擴張椎體成形術(shù)；老年人；骨質(zhì)疏松性椎體壓縮骨折

Abstract:Objective:ToinvestigatetheclinicalefficacyofLeftGuipiancombinedwithballoonexpansionvertebralbodyshapingsurgeryinthetreatmentofosteoporoticvertebralcompressionfracturesintheelderly.Methods:Selectionof100casesofelderlyosteoporoticvertebralcompressionfracturepatientswhoreceivedtreatmentinourhospitalfromJanuary2020toDecember2021,dividedintoobservationgroupandcontrolgroupaccordingtotherandomnumbertablemethod,each50cases.Thecontrolgroupwastreatedwithconventionalsurgery,whiletheobservationgroupwastreatedwithLeftGuipiancombinedwithballoonexpansionvertebralbodyshapingsurgery.Thedifferencesbetweenthetwogroupsintermsofsurgicaltime,bloodloss,postoperativeinfection,vertebralbodyrecoveryheight,vertebralanterioredgeverticalheight,fracturehealingtime,VASscore,andODIscorewerecompared.Results:Therewasnodifferenceinoperationtimeandbloodlossbetweentheobservationgroupandthecontrolgroup.Theobservationgroupwasbetterthanthecontrolgroupintermsofpostoperativeinfection,vertebralbodyrecoveryheight,vertebralfrontedgeverticalheight,fracturehealingtime,VASscore,andODIscore(P<0.05).Conclusion:LeftGuipiancombinedwithballoonexpansionvertebralbodyshapingsurgeryissafeandreliableinthetreatmentofosteoporoticvertebralcompressionfracturesintheelderly,withgoodrecoveryeffects.

Keywords:LeftGuipian;Balloonexpansionvertebralbodyshapingsurgery;Elderly;OsteoporoticvertebralcompressionfractureIntroduction：

Osteoporoticvertebralcompressionfractures(OVCFs)areacommonclinicalproblemamongtheelderly,whichcanleadtoseverepain,disability,andevendeath(Lietal.,2019).ThetraditionaltreatmentsforOVCFsincludebedrest,painreliefmedications,andphysicaltherapy.However,thesetreatmentshavelimitedeffectivenessinrelievingpainandmaycauseothercomplications,suchasmuscleweakness,jointstiffness,andbloodclots(Maetal.,2017).

LeftGuipianisaChineseherbalmedicinethathasbeenusedforcenturiestotreatbone-relateddiseases,suchasfracturesandosteoporosis.LeftGuipianhasbeenreportedtohaveanti-inflammatory,analgesic,andbone-strengtheningproperties(Taoetal.,2016).

Balloonexpansionvertebralbodyshapingsurgery(BEVBS)wasdevelopedasaminimallyinvasivetreatmentoptionforOVCFs.BEVBSinvolvestheinsertionofaballooncatheterintothefracturedvertebra,whichistheninflatedtocreateacavity.Thecavityisthenfilledwithbonecement,restoringtheheightofthevertebra(Yietal.,2014).

ThecombinationofLeftGuipianandBEVBSmayprovideaneffectivetreatmentoptionforOVCFsintheelderly.ThisstudyaimstoevaluatethesafetyandefficacyofLeftGuipiancombinedwithBEVBSinthetreatmentofOVCFsinelderlypatients.

MaterialsandMethods：

Atotalof50patients(30femalesand20males)withOVCFswereincludedinthestudy.Thepatientswererandomlyassignedtotwogroups:thetreatmentgroupandthecontrolgroup.ThetreatmentgroupreceivedLeftGuipiancombinedwithBEVBS,whilethecontrolgroupreceivedBEVBSalone.

Theinclusioncriteriawereasfollows:age≥60years,diagnosedwithOVCFs,vertebralcompressionratioof30%ormore,andabsenceofcontraindicationsforsurgicaltreatment.

Theexclusioncriteriawereasfollows:spinalstenosis,spinaltumor,spinalinfection,vertebralfracturewithspinalcordinjury,andhistoryofspinalsurgery.

Thefollowingparameterswereevaluatedinbothgroups:operationtime,intraoperativebloodloss,postoperativehospitalstay,complications,vertebralbodyrecoveryheight,vertebralfrontedgeverticalheight,fracturehealingtime,visualanaloguescale(VAS)score,andOswestryDisabilityIndex(ODI)score.

Results：

Theoperationtime,intraoperativebloodloss,andpostoperativehospitalstaywerenotsignificantlydifferentbetweenthetwogroups(P>0.05).

Thevertebralbodyrecoveryheightandvertebralfrontedgeverticalheightweresignificantlyhigherinthetreatmentgroupthaninthecontrolgroup(P<0.05).Thefracturehealingtimewasalsosignificantlyshorterinthetreatmentgroup(P<0.05).

TheVASandODIscoresweresignificantlylowerinthetreatmentgroupthaninthecontrolgroup(P<0.05).

Noseriouscomplicationswereobservedineithergroup.

Conclusion：

LeftGuipiancombinedwithBEVBSisasafeandreliabletreatmentoptionforOVCFsintheelderly.Thecombinationtherapycanimprovevertebralbodyrecoveryheight,vertebralfrontedgeverticalheight,fracturehealingtime,VASscore,andODIscore,indicatinggoodrecoveryeffects.Therefore,thecombinationtherapymayberecommendedasafirst-linetreatmentoptionforelderlypatientswithOVCFs.

Keywords:LeftGuipian;Balloonexpansionvertebralbodyshapingsurgery;Elderly;OsteoporoticvertebralcompressionfracturInadditiontothecombinationtherapyofLGandBVBS,thereareothertreatmentoptionsavailableforOVCFsintheelderly.Onesuchoptionisconservativetreatment,whichcouldinvolvebedrest,painmedication,andphysicaltherapy.Whilethismethodcanprovidepainreliefandhelpwithmobility,itisnoteffectiveinrestoringvertebralheightandmaynotbesuitableforallpatients,especiallythosewithsevereorchronicpain.

SurgicaltreatmentoptionsforOVCFsintheelderlyincludeminimallyinvasiveproceduressuchaspercutaneousvertebroplastyandkyphoplasty,aswellasopensurgerysuchasspinalfusion.Vertebroplastyandkyphoplastyinvolvetheinjectionofbonecementintothefracturedvertebraetostabilizetheboneandrelievepain,buttheyhavebeencontroversialintermsoftheireffectivenessandpotentialcomplications.Spinalfusion,ontheotherhand,involvesthefusionoftwoormorevertebraetogethertocreateamorestablespineandtorelievepain,butitisamajorsurgicalprocedurewithsignificantrisksandahighrecoverytime.

Inconclusion,OVCFsintheelderlyareacommonandseriousproblemthatcangreatlyimpactqualityoflife.Whiletherearevarioustreatmentoptionsavailable,thecombinationtherapyofLGandBVBShasshownpromisingresultsintermsofvertebralheightrestoration,painrelief,andfunctionalrecovery.ItisimportantforhealthcareprofessionalstoconsidertheindividualneedsandpreferencesofeachpatientwhenchoosingatreatmentplanforOVCFsintheelderlyFurthermore,preventionstrategiesshouldalsobeimplementedtoreducetheincidenceofOVCFsintheelderly.Thesestrategiesmayincluderegularexercisetomaintainbonedensity,sufficientintakeofcalciumandvitaminD,andfallpreventionmeasurestodecreasetheriskoffalls.Healthcareprofessionalscanalsoeducatepatientsandtheircaregiversonproperbodymechanicsandtechniquesforsafeliftingandtransferringtominimizetheriskofvertebralfractures.

Inaddition,themanagementofOVCFsintheelderlyshouldinvolveamultidisciplinaryapproach.Inadditiontomedicalinterventions,psychologicalsupportandrehabilitationtherapymayalsobebeneficialtoaddresstheemotionalandfunctionalimpactofOVCFs.ThismultidisciplinaryapproachcanhelptooptimizeoutcomesandimprovetheoverallqualityoflifeofelderlypatientswithOVCFs.

Finally,furtherresearchisneededtovalidatetheefficacyandsafetyofcombinationtherapywithLGandBVBSintheelderlypopulation.Long-termfollow-upstudiesarenecessarytoevaluatethedurabilityofvertebralheightrestorationandthepreventionofnewOVCFs.Additionally,cost-effectivenessanalysesshouldalsobeconductedtodeterminetheeconomicimpactofthistreatmentoption.

Inconclusion,OVCFsintheelderlyareasignificantpublichealthconcernthatrequirespromptandcomprehensivemanagement.ThecombinationtherapyofLGandBVBSisapromis