【論文摘要】The Effects of Percutaneous Vertebroplasty on Respiratory Parameters in Patients With Osteoporotic Vertebral Compression Fractures

【論文摘要】經皮椎體成型術治療對骨質疏鬆性脊椎壓迫性骨折病人之呼吸功能影響

吳至翔(Zhi-Xiang Wu) ； 馬景侯(Ching-Hou Ma) ； 蔡昆霖(Kun-Ling Tsai)

《物理治療》 46卷4期 (2021/12) Pp. 302-303

https://doi.org/10.6215/FJPT.202112.P07

摘要

Background and Purpose: The vertebral compression fractures (VCFs) cause severe back pain, lead to postural changes. Besides, past studies showed VCFs increase the risk of pulmonary functions decline and decrease the peak expiratory flows rate (PEFR). The percutaneous vertebroplasty (PVP) provides pain relief and stability to the vertebral body. However, whether the respiratory-related parameters could be improved after the PVP is still limited. Methods: The measurements included the back pain scale, pulmonary function tests (FVC, FEV_1, PEFR), respiratory muscles strength (MIP and MEP), and the chest mobility test (rib expansion). The same physical therapist measured the participants before the PVP (1st Test), 24 hours after the PVP (2nd Test), one week after discharge (3rd Test), and three weeks after discharge (4th Test). Results: We enrolled 32 participants from orthopedics outpatient, E-Da hospital. Results showed that PVP led to significant improvements in back pain scale (1st Test = 3.00 ± 1.40; 2nd Test = 1.00 ± 1.00; p ＜ 0.001) and chest mobility (1st Test = 0.80 ± 0.60; 2nd Test =1.00 ± 0.60; p = 0.001). Comparing to one week after discharge (1st Test versus 3rd Test), MIP (1st Test = 70.80 ± 42.00; 3rd Test = 82.40 ± 44.30; p = 0.029), FEV1 (1st Test = 1.06 ± 0.35; 3rd Test = 1.29 ± 0.50; p = 0.013), and MVV (1st Test = 33.51 ± 22.01; 3rd Test = 41.43 ± 15.97; p = 0.047) also showed a significant increase. However, the improvements of MIP (1st Test = 61.84 ± 35.06; 4th Test = 65.98 ± 34.77; p = 0.36) and FEV1 (1st Test = 1.09 ± 0.38; 4th Test = 1.20 ± 0.47; p = 0.541) did not extend to 3 weeks after discharge (1st Test versus 4th Test). Conclusions: For patients with VCFs, the decline in respiratory function is one of the symptoms. The PVP can solve the patient's pain problem (both resting and aggravating pain) and increase chest mobility immediately after the operation. And the MIP, FEV_1, and MVV would recover in one week after discharge. However, only pain status (resting and aggravating pain), MVV, and chest mobility indicated significant improvement at long-term effect (until three weeks after discharge). Clinical Relevance: According to the result, we will consider adding the respiratory muscle training program to the treatment protocol for patients with osteoporotic VCFs. Attempt to enhance the pulmonary performance.