老年女性急性背痛併有脊柱壓迫性骨折之部位與形態研究

Location and Type of Vertebral Compression Fractures in Aged Women with Acute Back Pain

林經凱(Ching-Kai Lin) ； 魏大森(Ta-Sen Wei) ； 楊博仁(Po-Jen Yang)

《台灣復健醫學雜誌》 32卷4期 (2004/12) Pp. 181-186

https://doi.org/10.6315/2004.32(4)02

摘要

老年女性之急性背痛有不少比例是因脊柱壓迫性骨折所引起，其間接致死率雖不似髖骨骨折這麼高，但劇烈疼痛對患者日常生活功能及社交活動所造成的影響不容小覰。本研究探討這族群中脊柱壓迫性骨折部位與形態之分佈，及其與骨質密度之關係。
研究以病歷調閱及X光片判讀的方式進行，收集八十七年七月至九十年六月期間因急性背痛於復健科往院治療並診斷為脊柱壓迫性骨折之女性患者，計126例；排除年紀小於60歲、重複往院、有明顯外傷病史者。
研究之有效樣本90例，計有108節脊椎壓迫性骨折。以形態區分：前楔形骨折(anterior wedge fracture)65節(60 %)，雙凹形骨折(concave fracture)有30節(28%)，塌陷形骨折(crush fracture)則有13節(12 %)。以部位區分：第一腰椎31節(29%)，第十二胸椎30節(28%)，第三腰15節(14%)，第二腰椎13節(12%)。進一步分析發現患者骨折之形態與其年齡或骨質密度沒有差異(p=0.35 vs 0.17)，而骨折程度與骨質密度之高低亦無顯著相關(p=0.34)。
老年女性急性背痛的脊柱壓迫性骨折最常見的部位是胸腰椎交界處，形態以前楔形骨折最多，而骨折的形態與患者年紀或骨質密度並無顯著關聯。

關鍵字

骨質密度 ； 脊柱壓迫性骨折 ； 骨質疏鬆症

並列摘要

In many cases acute back pain in aged women is caused by vertebral compression fractures. Although the indirect mortality rate among these patients is not as high as in those with hip fractures, the effect of acute back pain on patients’ daily lives and social activities should not be underestimated. This study was performed to understand the distribution of the location and type of vertebral compression fractures in this particular group of women and their relations to bone mineral density.
This retrospective study consisted of medical record and X-ray examinations of 126 women patients who complained of acute back pain, were diagnosed with vertebral compression fracture(s) and hospitalized for rehabilitation from July 1998 to June 2001. Patients younger than 60, who were hospitalized more than once and who had obvious external injuries were excluded from the study.
The study included complete records of 90 patients with 108 vertebral compression fractures. Several different types of fractures were found: 65 (60%) anterior wedge fractures, 30 (28%) concave fractures and 13 (12%) crush fractures. Fracture locations were at L1 (31, 29%), T12 (30, 28%), L3 (15, 14%) and L2 (13, 12%). Further analysis showed no difference between the type of fracture and the patient’s age or bone mineral density (p=0.35 vs. 0.17).
The most common location of vertebral compression fractures in aged women with acute back pain was the lumbar spine where it met the thoracic spine; the most common fracture type was a wedge fracture. No significant correlation was found between fracture type and patients’ age or bone mineral density.

並列關鍵字

bone mineral density ； vertebral compression fracture ； osteoporosis