骨质疏松性椎体压缩性骨折老年患者不同PKP术后应用注射用重组特立帕肽联合康复锻炼对骨质疏松椎体T值和CT值的变化观察

Observation on the Changes of T Value and CT Value of Osteopolytic Vertebra After Different PKPS in Elderly Patients with OVCFs by Recombinant Teriparatide for Injection Combined with Rehabilitation Exercise

目的探讨骨质疏松性椎体压缩性骨折(OVCFs)老年患者不同经皮椎体球囊后凸成形术(PKP)后应用注射用重组特立帕肽联合康复锻炼对骨质疏松椎体T值和CT值的变化观察。方法选取2019年7月至2022年3月我院收治的120例老年OVCFs患者作为研究对象,按照干预方法的不同分为单次球囊扩张PKP治疗组与多点扩张PKP治疗组,均为60例,多点扩张PKP治疗组采取多点球囊PKP术,单次球囊扩张PKP治疗组采取单点球囊PKP术,所有患者术后均接受注射用重组特立帕肽联合康复锻炼干预。观察并比较两组患者的T值、CT值、腰痛功能评定表(JOA)、Oswestry功能障碍指数问卷表(ODI)、视觉模拟评分法(VAS)及再骨折情况。结果多点扩张PKP治疗组患者的T值(t=9.130,P=0.000)、CT值(t=39.140,P=0.000)显著低于单次球囊扩张PKP治疗组。治疗后,多点扩张PKP治疗组ODI、VAS评分低于治疗前和同期单次球囊扩张PKP治疗组(P<0.05)。多点扩张PKP治疗组再骨折率低于单次球囊扩张PKP治疗组(P<0.05),两组治疗方式的骨水泥注入量和骨水泥渗漏情况差异无统计学意义(P>0.05)。结论多点扩张PKP术后应用注射用重组特立帕肽联合康复锻炼,可有效改善患者椎体T、CT值、腰椎功能和疼痛程度,降低再骨折和不良反应发生情况。

Objective To investigate the changes of T value and CT value of osteoporotic vertebral bodies in elderly patients with osteoporotic vertebral compression fractures(OVCFs)after different percutaneous balloon kyphoplasty(PKP)combined with rehabilitation exercise.Methods A total of 120 elderly patients with OVCFs admitted to our hospital from July 2019 to March 2022 were selected as research objects.According to different intervention methods,they were divided into single balloon dilatation PKP treatment group and multi-point dilatation PKP treatment group(60 cases in each growp).Multi-point dilatation PKP treatment group was treated with multi-point balloon PKP.Single balloon dilatation PKP treatment group received single point balloon PKP,and all patients received recombinant teriparatide for injection combined with rehabilitation exercise intervention after surgery.T value,CT value,low back pain Function Assessment Scale(JOA),Oswestry Disability Index Questionnaire(ODI),visual analog scale(VAS),and refracture were observed and compared between the two groups.Results The T value(t=9.130,P=0.000)and CT value(t=39.140,P=0.000)in multipoint dilated PKP group were significantly lower than those in single balloon dilated PKP group.After treatment,ODI and VAS scores in multipoint PKP dilated group were lower than those before treatment and in the same period of single balloon dilated PKP group(P<0.05).The refracture rate of multipoint PKP group was lower than that of single balloon PKP group(P<0.05).There was no significant difference in the amount of bone cement injected and the leakage of bone cement between the two treatment methods(P>0.05).Conclusion The application of recombinant Teriparatide for injection combined with rehabilitation exercise after multipoint PKP dilation can effectively improve the vertebral T,CT value,lumbar function and pain degree,and reduce the incidence of refracture and adverse reactions.