PKP微创治疗联合唑来膦酸对老年胸腰椎骨质疏松性骨折患者的效果

Effect of PKP Minimally Invasive Therapy Combined with Zoledronic Acid on Elderly Patients with Thoracolumbar Osteoporotic Fracture

目的:探讨经皮椎体后凸成形术(PKP)微创治疗联合唑来膦酸对老年胸腰椎骨质疏松性骨折患者的效果。方法:选择2019年1月—2022年8月南京市高淳人民医院收治的85例老年胸腰椎骨质疏松性骨折患者为研究对象,根据治疗方式分为联合组(n=44,PKP微创治疗联合唑来膦酸)与对照组(n=41,PKP微创治疗)。比较两组术前、术后2个月骨代谢指标[血清碱性磷酸酶(BALP)、空腹骨钙素(BGP)]水平、日本骨科协会(Japanese Orthopaedic Association,JOA)评分及手术效果。结果:术前,两组血清BALP、空腹BGP水平及JOA评分比较,差异无统计学意义(P>0.05);术后2个月,两组血清BALP、空腹BGP水平及JOA评分较术前均升高,且联合组高于对照组,差异有统计学意义(P<0.05)。两组手术效果比较,差异有统计学意义(P<0.05);联合组手术优良率高于对照组,差异有统计学意义(P<0.05)。结论:PKP微创治疗联合唑来膦酸应用于老年胸腰椎骨质疏松性骨折患者,有利于改善骨代谢指标,进一步提高手术优良率,减轻腰痛症状。

Objective:To investigate the effect of percutaneous kyphoplasty(PKP)minimally invasive therapy combined with Zoledronic Acid on elderly patients with thoracolumbar osteoporotic fractures.Method:A total of 85 elderly patients with thoracolumbar osteoporotic fractures who admitted to Nanjing Gaochun People's Hospital from January 2019 to August 2022 were selected as the study objects,and divided into the combined group(n=44,PKP minimally invasive therapy combined with Zoledronic Acid)and the control group(n=41,PKP minimally invasive therapy)according to the treatment methods.The levels of bone metabolism indexes[serum alkaline phosphatase(BALP),fasting osteocalcin(BGP)],Japanese Orthopaedic Association(JOA)score before and 2 months after surgery and surgical effect were compared between two groups.Result:Before surgery,there were no significant differences in serum BALP,fasting BGP level and JOA score between two groups(P>0.05);after 2 months of surgery,the serum BALP,fasting BGP levels and JOA scores in two groups were higher than those before surgery,and those in the combined group were higher than those in the control group,the differences were statistically significant(P<0.05).The difference in surgical outcomes between two groups was statistically significant(P<0.05);the excellent and good rate of surgery in the combined group was higher than that in the control group,and the difference was statistically significant(P<0.05).Conclusion:PKP minimally invasive therapy combined with Zoledronic Acid in elderly patients with thoracolumbar osteoporotic fractures is beneficial to improve the bone metabolism indexes,further increase the excellent rate of surgery,and reduce the symptoms of low back pain.