CONSERVATIVE TREATMENT AND VITAMIN D LEVELS IN PATIENTS WITH SPINAL FRACTURES

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.摘要 研究目的：评估低能量脊柱骨折保守治疗患者的疼痛、功能能力及血清维生素D水平的变化情况。 研究方法：2017年1月至2021年3月期间，纳入年龄大于40岁的低能量脊柱骨折患者，予以为期6个月的保守治疗。分别于治疗前后评估患者的视觉模拟评分法（Visual Analogue Scale，VAS）、Oswestry功能障碍指数（Oswestry Disability Index，ODI）及Cobb角；于首次门诊随访时检测患者血清维生素D水平，并调查患者既往是否确诊骨质疏松症或曾发生骨折。 研究结果：本研究共纳入105例患者，其中女性占比70.5%，平均年龄73.1岁。受试者平均血清维生素D水平为25.3 ng/mL，75%的患者存在维生素D缺乏。8例患者（7.62%）既往确诊骨质疏松症，10例患者（9.52%）报告曾发生骨折。治疗前后对比显示，VAS疼痛评分平均降低5.5分；ODI平均升高1个百分点；骨折节段的后凸Cobb角平均增加4.3°。 研究结论：保守治疗可改善患者疼痛症状，且患者功能能力得以维持。血清维生素D水平低下与更复杂的骨折相关。本研究证据等级为Ⅲ级，属于回顾性研究。