左归丸联合球囊扩张椎体成形术治疗老年骨质疏松性椎体压缩骨折的临床疗效观察

左归丸联合球囊扩张椎体成形术治疗老年骨质疏松性椎体压缩骨折的临床疗效观察摘要：目的：探讨左归丸联合球囊扩张椎体成形术治疗老年骨质疏松性椎体压缩骨折的临床疗效。方法：选取2020年1月至2021年12月在我院接受治疗的老年骨质疏松性椎体压缩骨折患者100例，按照随机数字表法分为观察组和对照组各50例。对照组采用常规手术治疗，观察组采用左归丸联合球囊扩张椎体成形术治疗。比较两组在手术时间、出血量、术后感染、椎体恢复高度、椎体前缘垂直高度、骨折愈合时间、VAS评分、ODI评分等方面的差异。结果：观察组和对照组手术时间、出血量无差异，观察组术后感染、椎体恢复高度、椎体前缘垂直高度、骨折愈合时间、VAS评分、ODI评分均优于对照组（P<0.05）。结论：左归丸联合球囊扩张椎体成形术治疗老年骨质疏松性椎体压缩骨折具有安全可靠、恢复效果良好的疗效。

关键词：左归丸；球囊扩张椎体成形术；老年人；骨质疏松性椎体压缩骨折

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