نتایج درمان شکستگی فشاری ستون فقرات: مقایسه روش غیرجراحی با کیفوپلاستی و ورتبروپلاستی

مرادی, بهرام; فتاحیان, آراد; فتاحیان, رضا

doi:10.22034/ijos.2022.347358.1027

نتایج درمان شکستگی فشاری ستون فقرات: مقایسه روش غیرجراحی با کیفوپلاستی و ورتبروپلاستی

نوع مقاله : مقاله اروجینال

نویسندگان

بهرام مرادی ¹

آراد فتاحیان ²

رضا فتاحیان ³

¹ دستیار. دانشکدة علوم پزشکی کرمانشاه، کرمانشاه، ایران.

² دانشکدة علوم پزشکی کرمانشاه، کرمانشاه، ایران.

³ دانشیار. دانشکدة علوم پزشکی کرمانشاه، کرمانشاه، ایران.

https://doi.org/10.22034/ijos.2022.347358.1027

چکیده

زمینه و هدف: شکستگی‌های فشاری ستون فقرات از عوارض شایع پوکی استخوان هستند که منجر به درد مداوم، ناتوانی در انجام فعالیت‌های روزانه و کاهش قابل توجه کیفیت زندگی می‌شوند. کیفوپلاستی و ورتبروپلاستی (Kyphoplasty and Vertebroplasty) دو روش درمانی نیمه‌تهاجمی برای درمان این عارضه هستند. بنابراین هدف از این تحقیق ارزیابی و مقایسة نتایج درمانی حاصل از استفاده از دو روش ذکر شده با درمان طبی غیرجراحی در بیماران مبتلا به شکستگی فشاری ستون فقرات بود.
مواد و روش‌ها: موارد شکستگی فشاری ستون فقرات قفسه سینه مراجعه کننده به 2 بیمارستان آموزشی طی یک دوره 2 ساله (1394 تا 1396) به صورت گذشته‌نگر مورد بررسی قرار گرفت. نتایج 3 روش درمانی غیرجراحی، ورتبروپلاستی و کیفوپلاستی با بررسی نمودار و همچنین پرسش و معاینة مستقیم با حداقل پیگیری در یک سال مقایسه شد. ارزیابی VAS (Visual Analog Scale)، دردناک و وضعیت عملکردی شاخص ناتوانی ODI (Oswestry Disability Index) و فرم کوتاه SF-36 تکمیل شد.
یافته‌ها: از مجموع 138 مورد شکستگی فشاری ستون فقرات قفسه سینه تنها 96 مورد معیارهای ورود را داشتند و وارد مطالعه شدند. 42 بیمار مرد و 54 بیمار زن مورد بررسی قرار گرفتند. بیماران حداقل 3 ماه و حداکثر 1 سال (میانگین = 5/7 ماه) پیگیری داشتند. نمرة VAS در گروه غیرجراحی 32/1±75/6، در ورتبروپلاستی 94/1±58/3 و در کیفوپلاستی 64/1±67/2 بود. نمرات ODI برای غیرجراحی، ورتبروپلاستی و کیفوپلاستی به ترتیب: 4/14±82/56، 40/15±28 و 52/13±64/25 بود. نمرات SF-36 در هر 3 روش درمانی تقریباً مشابه بود.
نتیجه‌گیری: دو روش ورتبروپلاستی و کیفوپلاستی در مقایسه با درمان غیرجراحی به میزان قابل توجهی درد را کاهش داده و کیفیت زندگی و توانایی کار را بهبود بخشیده اند. بنابراین، دو روش درمان مبتنی بر جراحی، تکنیک‌های ارجح برای شکستگی‌های فشاری ستون فقرات هستند.

کلیدواژه‌ها

پوکی استخوان

ورتبروپلاستی

کیفوپلاستی

شکستگی ستون فقرات

درمان محافظه‌کارانه

عنوان مقاله English

Treatment Results of Compression Spine Fracture: Comparison of Non-Surgical with Kyphoplasty and Vertebroplasty

نویسندگان English

Bahram Moradi ¹

Arad Fatahian ²

Reza Fatahian ³

¹ residency, Kermanshah University of Medical science, Kermanshah, Iran.

² Kermanshah University of Medical science, Kermanshah, Iran.

³ Associate professor, Kermanshah University of Medical science, Kermanshah, Iran.

چکیده English

Background: Compression fractures of the spine are common complications of osteoporosis that lead to persistent pain, inability to perform daily activities, and a significant reduction in quality of life. Kyphoplasty and vertebroplasty are two semi-invasive treatments for this complication. Therefore, the purpose of this research was to evaluate and compare the treatment results obtained from the use of the two mentioned methods with non-surgical medical treatment in patients with compression fracture of the spine.
Methods: The cases of thoracic spine compression fracture referring to 2 teaching hospitals during a 2-years period (2015 to 2017) were retrospectively studied the results of 3 treatment methods of non-surgical, vertebroplasty and Kyphoplasty were compared by chart review and also direct questioning and examination at a minimum follow-up of one year. The evaluation of pain by VAS, and functional status Oswestry Disability Index (ODI) and SF-36 short form were completed.
Results: From total of 138 cases of compression thoracic spine fracture only 96 had the inclusion criteria and were entered into the study. 42 male and 54 female patients were evaluated. The patients had a minimum of 3 months and maximum of 1 year (Mean=7.5 months) follow-up. VAS score in non-surgical group was 6.75±1.32, in vertebroplasty was 3.58±1.94 and in Kyphoplasty was 2.67±1.64. The ODI scores were: 56.82±14.4, 28±15.40, and 25.64±13.52 for non-surgical, vertebroplasty and Kyphoplasty respectively. The SF-36 scores were almost similar in all 3 treatment methods.
Conclusion: The two methods of vertebroplasty and Kyphoplasty, in comparison with non-surgical treatment, had significantly reduced pain and better quality of life and ability of work. Therefore the two surgical treatments are preferred techniques for compression spine fractures.

کلیدواژه‌ها English

Osteoporosis

Vertebroplasty

Kyphoplasty

Spinal fracture

Conservative treatment

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