骨质疏松性脊柱骨折患者经皮椎体后凸成形术治疗的有效性及对患者血清CTX-Ⅰ、IGF、睾酮水平的影响

Effectiveness of percutaneous Kyphoplasty in Patient with osteoporotic Ridge Fractures and its Effect on Serum CTX-I,IGF and Testosterone Levels

目的探讨经皮椎体后凸成形术(PKP)对骨质疏松性脊柱骨折患者血清I型胶原蛋白C末端异物肽(CTX-Ⅰ),胰岛素样生长因子(IGF)和睾酮(T)的影响。方法分析2017年1月至2019年8月收治的52例骨质疏松性脊柱骨折患者的数据。根据治疗方法不同,分为采用PKP治疗(PKP组)32例和经皮椎体成形术治疗(PVP组)20例。比较两组患者术前1天,术后1天、1个月、3个月和6个月的Oswestry残疾指数(ODI),以及12个月后的CTX和T、IGF水平。将PKP组手术前后的椎骨中位高度与受伤椎骨的Cobb角进行比较。结果所有患者在治疗后均随访6~16个月。与PVP组相比,PKP组术后1天、1个月、3个月和6个月的ODI值较低,差异具有统计学意义(P<0.05)。术后1天、1个月、3个月和6个月,PKP组椎体高度有所改善,与术前相比有统计学意义(P<0.05)。PKP组术后1天,1个月,3个月和6个月以及手术前1天的后凸cobb角均无统计学差异(P<0.05)。两组在术后12个月时血清CTX-Ⅰ和IGF T水平比较差异显著(P<0.05)。结论与经皮椎体成形术治疗骨质疏松性脊柱骨折相比,PKP可以快速有效地缓解背痛,增加椎体强度,恢复椎体高度,并能够改善骨质疏松症相关因子水平。

Objective To investigate the effect of percutaneous kyphoplasty(PKP)on C-terminal foreign body peptide of serum type I collagen(CTX-Ⅰ),insulin-like growth factor(IGF)and testosterone(T)in patients with osteoporotic column fracture.Methods The data of 52 patients with osteoporotic column fractures from January 2017 to August 2019 were analyzed.The patients were divided into PKP group(32 cases)and PVP group(20 cases)according to different treatment methods.OSWESTRY disability index(ODI)at 1 day before operation,1day and 1,3 and 6 months postoperatively and CTX,T,IGF levels at 12 months postoperatively were compared between the two groups.In PKP group,the median vertebral height before and after operation was compared with the Cobb angle of the injured vertebrae.Results All patients were followed up for 6~16 months after treatment.Compared with PVP group,the ODI values of PKP group at 1 day,1 month,3 months and 6 months were significantly lower(P<0.05).At 1 day,1 month,3 month and 6 months after operation,the vertebral body height in PKP group was improved,which was significantly higher than that before operation(P<0.05).In PKP group,there was no significant difference in the posterior cobb angle at 1 day,1 month,3 months,6 months and 1 day before operation(P<0.05).The serum levels of CTX-Ⅰand IGF t in the two groups were significantly different at 12 months postoperatively(P<0.05).Conclusion Compared with percutaneous vertebroplasty for osteoporotic column fractures,PKP can quickly and effectively relieve back pain,increase vertebral strength,restore vertebral height,and improve the level of osteoporosis-related factors.