抗骨质疏松药物对经皮椎体后凸成形术后再发脊柱椎体压缩性骨折的影响

Anti-osteoporosis drugs influence on recurrence of spinal vertebral compression fractures that occurred postoperation of PKP

目的探讨抗骨质疏松联合用药对预防经皮椎体后凸成形术(PKP)后再发脊柱椎体压缩性骨折的影响。方法选择101例老年脊柱骨质疏松骨折经皮PKP术患者为研究对象,分为对照组33例和观察组68例。对照组术后给予常规治疗,观察组术后同时给予抗骨质疏松联合用药治疗。观察2组术后不同时间段(术后1个月、3个月、6个月)疼痛视觉模拟评分(VAS)、术前术后骨密度T值、椎体高度恢复情况、椎体骨折再发情况与远期临床疗效。结果观察组术后1个月、3个月、6个月VAS评分均明显低于对照组(P<0.05);观察组术后3个月、6个月骨密度T值明显高于对照组(P<0.05);术后6个月,观察组Cobb角明显低于对照组,伤椎椎体前缘高度比明显高于对照组,功能障碍指数问卷表(ODI)评分明显低于对照组(P<0.05);随访2年,观察组再发脊柱椎体压缩性骨折为7.35%,明显低于对照组的24.24%(P<0.05)。结论抗骨质疏松联合用药有助于缓解经皮椎体后凸成形术患者的疼痛程度,增强骨密度,改善椎体情况,降低脊柱椎体压缩性骨折的再发率,提高远期疗效。

Objective To discuss the precaution of the combination therapy of osteoporosis' influence on recurrence of spinal vertebral compression fractures that occurred postoperation of PKP. Methods 101 cases of elder spinal osteoporosis fracture patient who was cured by percutaneous PKP was selected as the object in the study. Divide the patient into two groups,control group included 33 cases and observation group included 68 cases. Conventional therapy was given to the observation group during the postoperation,and combination therapy of osteoporosis treatment was given to the control group. The Visual Analogue Scale Score( VAS),preoperative T value of postoperative bone mineral density,vertebral body height and vertebral fracture recurrence with long- term clinical efficacy were observed between two groups in different time after surgery. Results In observation group,VAS score were significantly lower than that in control group after one,three and six months( P < 0. 05). T value in observation group of bone mineral density significantly was higher than that in contrast group after three months and six months( P < 0. 05). Vertebral body circumstance and the forward curative effect:cobb angle of observation group was obviously lower than that in control group after 6 months,height ratio of injured vertebral anterior flange was significantly higher than that in control group,and ODI was significantly lower than the control group( P < 0. 05); Recurrence rate of vertebral body fracture: Followed up for two years,the ratio of recurrence of spinal vertebral body compression fractures of observation group was 7. 35%,which was significantly lower than that in control group which ratio was 24. 24%( P < 0. 05). Conclusion The combination therapy of osteoporosis is contribute to remit the degree of patient's pain who is occurred postoperation of PKP,strengthen the bone mineral density,improve vertebral body situation,reduce recurrence rate of spinal vertebral compression fractures,Improving the long- term curative effect.