椎体后凸成形术联合唑来膦酸治疗骨质疏松性椎体压缩骨折的临床疗效

Cfinical Efficacy of Kyphoplasty Associated with Zoledronic Acid in the Treatment of Osteoporotic Vertebral Compression Fractures

目的探讨采用椎体后凸成形术联合唑来膦酸治疗骨质疏松性椎体压缩性骨折的临床疗效。方法选择2013ff4月一2015年4月就诊的骨质疏松性椎体压缩骨折病例共76例，行椎体后凸成形术，术后3d内静脉滴注唑来膦酸注射液5mg。测量术前、术后与末次随访时伤椎椎体高度及后凸畸形角度，采用视觉模拟评分法（VAS）、Oswestry功能障碍指数（ODI）评定疗效，测量术前及末次随访时骨密度变化，记录术后再骨折情况。结果该组病例平均随访19．7个月。与术前相比，术后伤椎前、中椎体高度，Cobb，S角，VAS和ODI评分均显著改善（P〈0．05），末次随访时各项指标同术后相比差异无统计学意义（P〉0．05）。末次随访腰椎椎体和髋部骨密度较术前明显增高（P〈0．05）。随访期间3例患者出现新的椎体骨折。结论椎体后凸成形术联合唑来膦酸治疗骨质疏松性椎体压缩性骨折能有效缓解患者临床症状，改善生活质量，并且减少再骨折的发生。

Objective To explore the clinical efficacy of percutaneous kyphoplasty （PKP） associated with zoledronic acid in the treatment of osteoporotic vertebral compression fractures （OVCF）. Methods From April 2013 to April 2015, 76 patients with OVCFs who were treated in our hospital were analyzed. Within 3 days after PKP, these patients received intravenous 5 mg zoledronic acid. The height of the compromised vertebral body, the kyphotic angle were measured preoperatively, postoperatively and at the final follow-up. The clinical efficacy was assessed using visual analogue scale （VAS） score and Oswestry disability index （ODI）. The bone mineral density （BMD） were measured preoperatively and at the final follow-up. Postoperative new vertebral fractures were recorded. Results The mean follow-up time was 19.7 months. Compared with the preoperative values, the anterior and middle height of the compromised vertebral body, the Cobb＇s angle, VAS and ODI scores were significantly improved postoperatively （P 〈 0.05）. At the final follow-up, these values didn＇t differ significantly from the postoperative values （P 〉 0.05）. The BMD in the lumbar vertebral bodies and hips at the final follow-up was significantly higher than that before treatment. 3 postoperative new vertebral fractures were observed during the follow-up. Conclusion PKP associated with zoledronic acid can relieve the clinical symptoms, improve the quality of life, and reduce the incidence of subsequent fractures for patients with OVCFs.