骨质疏松性椎体压缩性骨折治疗进展研究

Research on progress in the treatment of osteoporotic vertebral compression fractures

椎体压缩性骨折是骨质疏松最常见的后遗症,椎体骨折与年龄的增长和骨质疏松的发病率直接相关。目前,许多治疗方案可用于骨质疏松椎体压缩骨折的管理,然而,确定最佳治疗方案的算法尚未开发。文章阐述了保守的疼痛管理通常是椎体压缩性骨折患者的一线治疗,最常用的疼痛控制药物是非类固醇抗炎药物和阿片类镇痛剂,但其他药物,包括双磷酸盐、降钙素和抗抑郁药可能仍然使用。当患者持续疼痛或随访X线片显示骨折进展时,应考虑椎体增强手术,包括椎体成形术和脊柱后凸成形术。目前需要开发更好的生物标志物和成像技术,在获得最佳治疗模式之前,必须进行进一步的临床试验。

Vertebral compression fractures are the most common sequela of osteoporosis.Vertebral fractures are directly related to the increase of age and the incidence rate of osteoporosis.At present,many treatment schemes can be used for the management of osteoporotic vertebral compression fractures.However,the algorithm to determine the best treatment has not been developed.Conservative pain management is usually the first-line treatment for patients with vertebral compression fractures.The most commonly used pain control drugs are non steroidal anti-inflammatory drugs and opioid analgesics,but other drugs,including bisphosphonates,calcitonin and antidepressants,may still be used.When patients have persistent pain or follow-up X-ray shows fracture progression,vertebral augmentation surgery should be considered,including vertebroplasty and kyphoplasty.At present,better biomarkers and imaging technology need to be developed,and further clinical trials must be carried out before the best treatment mode can be obtained.