| ObjectiveDo research on Osteoporotical Vertebral Compression Fractures (OVCFs) Patients'mid-and-long term quality of life(QOL) treated by two treatments: the Non-surgical treatment by integrated Traditional Chinese Medicine (TCM) and western medicine (WM) and the Surgical treatment by vertebroplasty. Compare the improvement from every dimensions of QOL and visual Analogue Scale (VAS), to provide a basis for more rational treatment selection in clinical work.Methods108 inpatients with OVCFs from January 2006 to December 2008 in guangdo ng provincial tcm hospital were analyzed retrospectively, in which there are 55 inpatients treated by the Non-surgical treatment and 53 inpatients treated by vertebroplasty. All patients were scored with The Short-term 36(SF-36), Statistical analysis was executed by SPSS 13.0 software, evalua te on the improvement of QOL from 8 dimensions respectively:Physical Fun ctioning(PF), Role-Physical(RP),BodilyPain(BP), General Health(GH), Vitality (VT), Social Functioning(SF), Role-Emotional(RE) and Mental Health(MH). An d at the same time the patients were scored with VAS to compare the pain improvement of two treatments. Then inputting the collected data into the database,using the statistical software SPSS13.0 to analyze and finally comes to conclusions.Results1. There were significant differences in PF,RF,BP between the two groups, the scores of the Non-surgical treatment group was better than that of vertebroplasty group. But there was no statistical significance between them in VT,SF,RE,MH.2. There was no statistical significance among the three Surgical procedures: Percutaneous Vertebroplasty(PVP), Percutaneous Kyphoplasty(PKP) and Spinal kyphoplasty bone expander system in Percutaneous Kyphoplasty(SKY) in BP,GH,VT,SF,RE,MH and VAS. (P>0.05). But there were significant differences in PF between the PKP and SKY(P<0.05).3. There was no statistical significance among the patients treated by vertebroplasty with different time after injury to surgery, different duration of bed rest, Unilateral or Bilateral transpedicular approach and different quantity of bone cement in 8 dimensions (P>0.05).4. There was no statistical significance between the two groups in VAS (P >0.05), the scores of the Non-surgical treatment group was better than that of vertebroplasty group.Conclusion1.Both the Non-surgical treatment by integrated Traditional Chinese Medicine (TCM) and western medicine(WM) and the Surgical treatment by vertebroplasty are valid to treat the OVCFs Patients, we could select the appropriate treatment according to the wishes of patients, economic status, physical condition.2. There were significant differences in PF,RF,RE,BP between the two groups, the scores of the Non-surgical treatment group was better than that of vertebroplasty group. So is it in VAS. Therefore, in the choice of treatment we must be strictly kept to the surgical indications.3. There was no statistical significance among the three Surgical procedures: PVP, PKPand SKY in BP,GH,VT,SF,RE,MH and VAS. But there were significant differences in PF between the PKP and SKY. Therefore, Selection of surgical procedure should be emphasized.4. There was no statistical significance among the patients treated by vertebroplasty with different time to surgery after injury in 8 dimensions. Therefore, no matter how long the course of disease, All the patients with clinical symptoms were diagnosed as OVCFs could try the vertebroplasty treatment.5. There was no statistical significance among the patients treated by vertebroplasty with Unilateral or Bilateral transpedicular approach in 8 dimensions. Therefore, we could choose Unilateral or Bilateral transpedicular approach according to personal habits and tolerance of patients.6. There was no statistical significance among the patients treated by vertebroplasty with different quantity of bone cement in 8 dimensions. Therefore, the quantity of bone cement could be moderate, we should not simply increase the quantity which may lead to the increasing of complications.7. There was no statistical significance among the patients treated by vertebroplasty with different duration of bed rest in 8 dimensions. Therefore, we could reduce the duration of bed rest as soon as possible after surgery and do some functional exercises to promote an early recovery and reduce the complications of bed rest.8. We should treat the patients with OVCFs not only during hospitalization but also after discharge. We should help them to improve the quality of life through a variety of ways in diet, living habits, drugs and so on... |
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