经皮椎体成形术联合阿仑膦酸钠治疗骨质疏松性胸腰椎骨折的效果及对患者预后的影响

Effect of Percutaneous Vertebroplasty Combined with Alendronate in the Treatment of Osteoporotic Thoracolumbar Fractures and Its Impact on Prognosis

目的:探讨经皮椎体成形术联合阿仑膦酸钠治疗骨质疏松性胸腰椎骨折的效果及对患者预后影响。方法:选取2020年1月-2021年1月萍乡市赣西医院收治的80例骨质疏松性胸腰椎骨折患者。将其按随机数字表法分为对照组与研究组,每组40例。对照组行经皮椎体成形术治疗,研究组在对照组基础上联合阿仑膦酸钠治疗。对比两组治疗前后视觉模拟评分法(visual analogue scale,VAS)评分、Oswestry功能障碍指数(Oswestry disability index,ODI)评分、骨代谢指标、伤椎后凸Cobb角、伤椎椎体前缘高度比。结果:研究组治疗后1周与治疗后3个月VAS评分、ODI评分均优于对照组(P<0.05)。两组治疗后1个月血钙(Ca)、血磷(P)对比,差异均无统计学意义(P>0.05);研究组治疗后1个月骨钙素(OST)、骨型碱性磷酸酶(BAP)均优于对照组(P<0.05)。研究组治疗后1个月伤椎后凸Cobb角、伤椎椎体前缘高度比均优于对照组(P<0.05)。结论:经皮椎体成形术联合阿仑膦酸钠可改善骨质疏松性胸腰椎骨折患者疼痛程度,改善骨代谢指标,有效维持伤椎后凸Cobb角、伤椎椎体前缘高度比,改善脊柱功能,具备一定临床意义。

Objective:To investigate the effect of percutaneous vertebroplasty combined with Alendronate in the treatment of osteoporotic thoracolumbar fractures and its effect on the prognosis of patients.Method:From January 2020 to January 2021,80 patients with osteoporotic thoracolumbar fracture admitted to Ganxi Hospital,Pingxiang City were selected.They were divided into control group and study group according to random number table method,40 cases in each group.The control group was treated with percutaneous vertebroplasty,and the study group was treated with Alendronate on the basis of the control group.The visual analogue scale(VAS)score,Oswestry disability index(ODI)score,bone metabolism index,Cobb angle of kyphosis of injured vertebra and anterior edge height ratio of injured vertebrae were compared between the two groups before and after treatment.Result:The VAS score and ODI score of the study group were better than those of the control group at 1 week after treatment and 3 months after treatment(P<0.05).There was no significant difference in serum calcium(Ca)and phosphorus(P)between the two groups at 1 month after treatment(P>0.05).Osteocalcin(OST)and bone-type alkaline phosphatase(BAP)in the study group were better than those in the control group at 1 month after treatment(P<0.05).1 month after treatment,Cobb angle of kyphosis of injured vertebra and anterior edge height ratio of injured vertebrae in the study group were better than those in the control group(P<0.05).Conclusion:Percutaneous vertebroplasty combined with Alendronate can improve the pain degree of patients with osteoporotic thoracolumbar fracture,improve bone metabolism indexes,effectively maintain the Cobb angle of the injured vertebra kyphosis,the height ratio of the anterior edge of the injured vertebra,and improve spinal function,which has certain clinical significance.