CONSERVATIVE TREATMENT AND VITAMIN D LEVELS IN PATIENTS WITH SPINAL FRACTURES

Q4 Medicine Coluna/ Columna Pub Date : 2023-04-17 DOI:10.1590/s1808-185120222201262485
B. Rodrigues, André Luís Sebben, Álynson Larocca Kulcheski, M. L. Benato, Pedro Grein del Santoro, X. S. Graells
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Abstract

ABSTRACT Objectives: Evaluate the evolution of pain, functional capacity, and vitamin D levels in conservatively treated patients with low-energy spinal fractures. Methods: Between January 2017 and March 2021, patients older than 40 years old affected by these fractures were selected and treated conservatively for six months. Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) scores and Cobb angle were evaluated pre- and post-treatment. Serum vitamin D levels were also measured at the first outpatient visit, and it was investigated whether the patient had a previous diagnosis of osteoporosis or previous fractures. Results: A total of 105 patients were analyzed, 70.5% of whom were women, with a mean age of 73.1 years. The average vitamin D level was 25.3 ng/mL, and hypovitaminosis was found in 75% of patients. Eight patients (7.62%) had a previous diagnosis of osteoporosis, and ten (9.52%) reported the occurrence of previous fractures. Regarding the VAS score, there was a mean reduction of 5.5 points of pain; for ODI, there was an average increase of 1 percentage point and an average increase of 4.3º of kyphosis in the fractured segment between pre- and post-treatment. Conclusion: The treatment improved pain, and patients maintained their functional capacity. Low levels of vitamin D were associated with more complex fractures. Level of evidence III; Retrospective Study.
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脊柱骨折患者的保守治疗和维生素d水平
目的:评估经保守治疗的低能性脊柱骨折患者疼痛、功能能力和维生素D水平的演变。方法:选取2017年1月至2021年3月期间年龄大于40岁的骨折患者,保守治疗6个月。治疗前后分别评价视觉模拟量表(VAS)、Oswestry残疾指数(ODI)评分和Cobb角。在第一次门诊就诊时也测量了血清维生素D水平,并调查了患者以前是否有骨质疏松症或骨折的诊断。结果:共分析105例患者,其中70.5%为女性,平均年龄73.1岁。平均维生素D水平为25.3 ng/mL, 75%的患者出现维生素缺乏症。8例(7.62%)患者既往诊断为骨质疏松症,10例(9.52%)患者既往发生过骨折。VAS评分方面,疼痛平均减轻5.5分;对于ODI,治疗前后骨折段的后凸度平均增加1个百分点,平均增加4.3º。结论:治疗后疼痛得到改善,患者功能得以维持。低水平的维生素D与更复杂的骨折有关。证据等级III;回顾性研究。
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来源期刊
Coluna/ Columna
Coluna/ Columna Medicine-Surgery
CiteScore
0.40
自引率
0.00%
发文量
32
审稿时长
10 weeks
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