Background: Osteoporotic vertebral compression fracture (OVCF) is a common injury in the elderly, often caused by low-energy injuries. Improper treatment will not only affect the stability and balance of the spine, but in severe cases will lead to neurological damage and increase the risk of death. This retrospective study aims to explore the principles of treatment of patients with the assessment system of thoracolumbar osteoporotic fracture (ASTLOF) in acute symptomatic thoracolumbar compression fractures when the ASTLOF score = 4 points.
Methods: The clinical data of patients with acute symptomatic thoracolumbar compression fractures admitted from February 2018 to February 2020 were retrospectively analyzed. Each patient was evaluated according to the ASTLOF scoring system, and patients with ASTLOF score = 4 were selected, a total of 108 patients. According to different treatment methods, they were divided into 32 cases in the non-surgical treatment (NST) group and 76 cases in the surgical treatment (ST)group. The visual analog score (VAS), Oswestry disability index (ODI), the recovery of injured vertebral body height, and the incidence of adjacent segment fractures were used for comprehensive evaluation.
Results: During the follow-up, the VAS score and ODI score showed that the early pain relief and functional improvement of the surgical treatment group were better than those of the conservative treatment group (P<0.05); the Cobb angle of the surgical treatment group was 3 months and 6 months after the operation, and the vertebral body was injured. The degree of improvement of margin height was better than that of the conservative treatment group (all P<0.05); in the surgical treatment group, 6 cases of adjacent vertebral fractures occurred after surgery, accounting for 7.89%, and 2 cases of the conservative treatment group had adjacent vertebral fractures, accounting for 6.25% There was no statistically significant difference between the two groups (P>0.05).
Conclusions: When the ASTLOF scoring system is used in the treatment of acute symptomatic thoracolumbar compression fractures, patients with ASTLOF score =4 should be treated with surgery in time, which can relieve pain early and quickly, perform functional exercises as soon as possible, and reduce complications related to long-term bed rest. Whether it increases the risk of adjacent vertebral fractures requires long-term follow-up studies in a large number of cases.