特立帕肽联合单侧入路PKP治疗骨质疏松性胸腰椎压缩性骨折的临床观察

Teriparatide combined with unilateral PKP in treatment of osteoporotic thoracolumbar compression fractures

目的特立帕肽联合单侧入路经皮椎体后凸成形术(PKP)治疗骨质疏松性胸腰椎压缩性骨折的临床疗效观察。方法将60名骨质疏松性胸腰椎压缩性骨折随机分为治疗组和对照组,治疗组30例和对照组30例。治疗组采用特立帕肽联合单侧入路PKP治疗,对照组采用特立帕肽联合双侧入路PKP治疗。采用Cobb角、椎体前缘高度(AVH)、Oswestry功能障碍指数(ODI)、视觉模拟量表(VAS)评分、骨密度(BMD)、注射水泥量、手术时间、术中射线次数、骨水泥渗漏来评估临床疗效。结果两组患者治疗后1个月及6个月Cobb角、AVH、VAS、ODI、腰椎BMD与治疗前相比较,差异有统计学意义(P<0.05),术后治疗组手术时间、X射线频率、输液量、水泥漏失量低于对照组(P<0.05),治疗组改善效果优于对照组(P<0.05)。结论特立帕肽联合单侧入路PKP是一种安全有效的治疗骨质疏松椎体压缩性骨折(OVCFs)的方法,减少手术时间和辐射暴露,增加骨密度。

【Objective】To observe the clinical effect of teriparatide combined with unilateral percutaneous kyphoplasty(PKP)in the treatment of osteoporotic thoracolumbar compression fractures.【Methods】Sixty patients with osteoporotic thoracolumbar compression fractures were randomly divided into treatment group(n=30)and control group(n=30).The treatment group was treated with teriparatide combined with unilateral PKP,and the control group was treated with teriparatide combined with bilateral PKP.Cobb angle,anterior vertebral height(AVH),Oswestry disability index(ODI),Visual Analogue Scale(VAS)score,bone mineral density(BMD),amount of cement injected,operation time,number of intraoperative rays and bone cement leakage were used to evaluate the clinical efficacy.【Results】There were significant differences in Cobb angle,AVH,VAS score,ODI and lumbar BMD between the two groups one month and six months after treatment(P<0.05).The operation time,X-ray frequency,infusion volume and cement leakage of the treatment group were significantly lower than those of the control group(P<0.05).The improvement effect of the treatment group was significantly better than that of the control group(P<0.05).【Conclusion】Teriparatide combined with unilateral PKP is a safe and effective method for the treatment of osteoporotic vertebral compression fractures(OVCFs),which can reduce the operation time and radiation exposure and increase bone mineral density.