老年脊柱压缩骨折患者行椎体成形术围手术期服用阿司匹林手术疗效及安全性评估

目的:观察老年骨质疏松椎体骨折(OVF)患者行椎体成形术(VP)围手术期服用阿司匹林的安全性及对手术疗效影响。方法:回顾性队列研究，分析2016年1月到2020年12月北京医院骨科136例行VP治疗OVF患者的临床资料，比较服用阿司匹林组(接受PVP术前服用阿司匹林，100 mg/d，并排除服用其他抗凝药物的患者)71...

Efficacy and safety of perioperative aspirin administration in elderly patients with spinal compression fractures undergoing vertebroplasty

Objective To investigate the efficacy and safety of perioperative aspirin use in elderly patients with osteoporotic vertebral fractures(OVF)undergoing vertebroplasty(VP).Methods This was a retrospective cohort study.Clinical data of 136 OVF patients treated with VP in our department from Jan.2016 to Dec.2020 were analyzed.Differences in clinical data,treatment efficacy,intraoperative and postoperative complications and hematomas were compared between the aspirin group(n=71,receiving aspirin100 mg/d before VP and not taking other anticoagulant drugs)and the control group(n=65,not taking aspirin).Results There was no significant difference in the analgesic score or physical activity scale score between the two groups before,1 week after surgery and at the last follow-up(P>0.05).There were significant differences in the visual analog score(VAS),the analgesic score and the physical activity scale score before,1 week after surgery and at the last follow-up within the aspirin group(7.12±1.33,2.37±1.01 vs.2.63±1.04,3.01±0.95,1.56±0.65 vs.1.61±0.57,2.75±0.53,1.32±0.63 vs.1.44±0.52,P<0.01).No surgical site infection,injury of large vessels,intraspinal hematoma or pulmonary embolism was found in the aspirin group or the control group during the follow-up period.There was no difference in intraoperative or postoperative blood loss(12±3.5 ml vs.11.0±3.6ml,t=1.60),cement injection volume for a single vertebral body(4.5±1.9 ml vs.4.0±1.7 ml,t=1.40),cement spillage(14 cases or 19.7%vs.9 cases or 17.0%,χ²=0.15),nerve root irritation(3 cases or 4.2%vs.1 case 1.9%,χ²=0.43),re-fractures(5 cases 7.0 vs.3 cases 5.7%,χ²=0.10)or spinal epidural hematoma(8 cases or 11.3%vs.5 cases or 9.4%,χ²=0.11)between the aspirin group and the control group(all P>0.05).Conclusions In OVF patients taking perioperative aspirin,the postoperative pain score,pain medication administration and mobility are significantly improved after VP,compared with pre-treatment.Surgical efficacy and safety show no significant difference between patients with and without aspirin administration.