| Objective:To investigate whether percutaneous kyphoplasty for elderly patients with thoracic fracture can improve the impaired lung function,and to further analyze which factors are related to the changes in lung function.Method: A total of 40 patients who received percutaneous kyphoplasty in the spine surgery department of Sichuan Orthopaedic Hospital from July 2019 to July 2020 and met the diagnostic and inclusion criteria,completed the whole study process and collected complete clinical materials were collected.Pulmonary function indicators(VC,FVC,FEV1,MVV),thoracic Cobb Angle,anterior edge height of the fracture vertebral body,Visual Analogue Scale,and Osewestry disability index were measured preoperatively,3 days after surgery,and 3 months after surgery.The above indexes measured at different time points were compared before and after the operation to observe which indexes were improved;The improvement values of all indicators(the improvement values of all indicators of lung function,the recovery values of vertebral body height,the reduction values of Cobb Angle of thoracic spine,the reduction values of VAS score and ODI score)between two different time points were further calculated,and the correlation between the improvement values of the above indexes and the improvement values of all indicators of lung function in patients was analyzed.Result:(1)The indicators of lung function(VC,FVC,FEV1,MVV),thoracic Cobb Angle,anterior edge height of fracture vertebral body,VAS score and ODI score were significantly improved 3 days after surgery and 3 months after surgery(P < 0.05),and the MVV measured 3 months after surgery was further increased on the basis of 3 days after surgery(P < 0.05).The VAS score and ODI score at 3 months after surgery were further decreased on the basis of 3 days after surgery(P < 0.05).There was no significant difference in other indexes between 3months after surgery and 3 days after surgery(P > 0.05).(2)The improvement of VAS score was positively correlated with the improvement of VC,FVC,FEV1 and MVV at 3 days postoperatively and preoperatively(VC:r=0.606,P < 0.05;FVC:r=0.408,P < 0.05;FEV1: r = 0.466,P < 0.05;MVV:r=0.462,P < 0.05),the improved value at 3 months postoperatively was positively correlated with the improved value of VC,FVC and FEV1(VC:r=0.538,P < 0.05;FVC:r=0.501,P <0.05;FEV1:r=0.447,P < 0.05),there was no correlation between the improvement value at 3 months and 3 days after the operation and the improvement value of all indicators of lung function(VC:r=0.152,P > 0.05;FVC:r=0.068,P > 0.05;FEV1: r= 0.109,P > 0.05;MVV:r=-0.111,P > 0.05).The improvement of ODI score was positively correlated with the improvement of VC,FVC and MVV at 3 days postoperatively and preoperatively(VC:r=0.437,P < 0.05;FVC:r=0.359,P < 0.05;MVV:r=0.509,P < 0.05),the improvement value from 3 months to preoperative was positively correlated with the improvement value of VC,FVC and MVV(VC:r=0.571,P < 0.05;FVC:r=0.460,P < 0.05;MVV:r=0.406,P < 0.05),the improvement value from 3 months to 3 days after surgery was positively correlated with the improvement value of MVV(MVV:r=0.465,P < 0.05).The improvement value of thoracic kyphotic Cobb Angle was positively correlated with the improvement value of pulmonary function indexes 3 days after operation and before operation(VC:r=0.720,P < 0.05;FVC:r=0.452,P < 0.05;FEV1:r=0.369,P < 0.05;MVV:r=0.431,P < 0.05).There was a positive correlation between the improvement value of VC and FVC 3 months postoperatively(VC:r=0.707,P < 0.05;FVC:r=0.387,P < 0.05),the improvement value from 3 months to 3 days after surgery had no correlation with the improvement value of all the indicators of lung function(VC:r=-0.216,P > 0.05;FVC:r=0.074,P > 0.05;FEV1,r = 0.309,P > 0.05;MVV:r=0.995,P > 0.05).The improvement value of the anterior edge height of the fracture vertebral body was positively correlated with the improvement value of VC,FVC and MVV 3 days postoperatively(VC:r=0.558,P < 0.05;FVC:r=0.465,P <0.05;MVV:r=0.348,P < 0.05).There was a positive correlation between the improvement value of VC and FVC 3 months postoperatively(VC:r=0.531,P < 0.05;FVC:r=0.530,P < 0.05),the improvement value from 3 months to 3 days after surgery was not correlated with the improvement value of all the indicators of lung function(VC:r=-0.302,P > 0.05;FVC:r=-0.158,P > 0.05;FEV1: r = 0.133,P >0.05;MVV:r=-0.010,P > 0.05).Conclusion:(1)After PKP treatment,the pain of elderly patients with thoracic fracture can be quickly relieved,the height of injured vertebra can be restored to a certain extent,the Cobb Angle of thoracic kyphosis can be improved,and the living ability can be improved.(2)PKP can improve the lung function of patients with thoracic fracture to some extent,and it is believed that the improvement of lung function in patients may be related to the relief of pain,the recovery of the height of the injured vertebra,the improvement of Cobb Angle of thoracic kyphosis and the improvement of mobility.(3)It is preliminarily demonstrated that PKP has potential efficacy in improving lung function damaged by thoracic vertebral fracture,which adds positive clinical significance to the treatment of elderly patients with thoracic vertebral fracture by PKP. |
PDF Full Text Request