目的:观察经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)联合鲑鱼降钙素治疗老年骨质疏松性椎体压缩骨折的疗效。方法:患者行PKP术后随机分为两组:对照组每日口服碳酸钙D3;治疗组术后予以鲑鱼降钙素和碳酸钙D3联合治疗。分别在术...目的:观察经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)联合鲑鱼降钙素治疗老年骨质疏松性椎体压缩骨折的疗效。方法:患者行PKP术后随机分为两组:对照组每日口服碳酸钙D3;治疗组术后予以鲑鱼降钙素和碳酸钙D3联合治疗。分别在术前、术后3d及6个月采用疼痛视觉模拟评分(visual analog scale,VAS)评分、活动能力评分及术后6个月患者伤椎高度丢失、邻近椎体骨折情况来评估两组治疗效果。结果:两组患者术后疼痛均有明显缓解,但与对照组相比,治疗组在术后6个月VAS评分和活动能力评分降低更为明显,患者伤椎高度丢失明显减轻,邻近椎体骨折显著减少,且差异有统计学意义(P均<0.05)。结论:PKP联合鲑鱼降钙素治疗骨质疏松性椎体压缩骨折在缓解疼痛、增强活动能力、减少伤椎高度丢失和邻近椎体骨折方面具有更好的疗效,值得临床推广。展开更多
<strong>Background:</strong> Zoledronic acid and teriparatide have been proved to be effective in improving bone metabolism and preventing fractures, but there is no clear clinical report on the efficacy o...<strong>Background:</strong> Zoledronic acid and teriparatide have been proved to be effective in improving bone metabolism and preventing fractures, but there is no clear clinical report on the efficacy of their combined application. <strong>Purpose:</strong> To discuss the clinical effect of zoledronic acid combined with teriparatide in perverting recurrent fracture of osteoporotic vertebral compressive fractures (OVCF) in the elderly after percutaneous kyphoplasty (PKP). <strong>Method:</strong> A randomized clinical trial was conducted at the First Affiliated Hospital of Hebei North University in China from September 2018 and September 2019. A total of 60 patients with OVCF were enrolled in the study (zoledronic acid: 20 cases;teriparatide: 20 cases;zoledronic acid + teriparatide: 20 cases). Observe and compare the changes of bone mineral density (BMD), pro-collagen type I N-terminal propeptide (PINP) and cross-linked C-terminal telopeptide of type I collagen (<em>β</em>-CTX) before surgery, 6 months and 1 year after surgery. At the same time, secondary fracture events and adverse reaction events were recorded during the follow-up period. <strong>Results:</strong> After normalized treatment, the bone metabolism indexes of PINP and <em>β</em>-CTX were improved and BMD was increased in three groups. <strong>Adverse Reactions:</strong> There was no statistical significance in the incidence of fever, gastrointestinal reactions and myalgia among the three groups (P > 0.05). The incidence of recurrent fractures in group A was higher than that in group C (P < 0.05), but there was no significant difference between group B and group C (P > 0.05). <strong>Conclusion:</strong> Zoledronic acid combined with teriparatide is superior to Zoledronic acid in preventing the risk of recurrent fracture after PKP for old patients with OVCF, but it has no significant advantage over teriparatide.展开更多
Objective:To evaluate the clinical efficacy of percutaneous kyphoplasty(PKP)in the treatment of osteoporotic vertebral compression fractures(OVCF)in the elderly by meta-analysis,and to provide a basis for clinical app...Objective:To evaluate the clinical efficacy of percutaneous kyphoplasty(PKP)in the treatment of osteoporotic vertebral compression fractures(OVCF)in the elderly by meta-analysis,and to provide a basis for clinical application.Methods:CNKI,Wanfang,Weipu,CBM,PubMed,the Cochrane Library and EMbase were retrieved by computer from the date of establishment to January 2019.The literature on randomized controlled trials of PKP and conservative treatment of OVCF was collected and diagnosed as thoracolumbar vertebral compression fracture by X-ray,CT,and MRI.Osteoporosis of thoracolumbar vertebrae(T<2.5)was determined by bone mineral density measurements.Age(>50 years old)and course of the disease(<3 months).Postoperative outcome indicators included at least one of the following indicators:visual analogue scale.VAS and Oswestry Dysfunction Index(ODI),changes of Cobb angle of diseased vertebrae and height of the anterior edge of diseased vertebrae.The quality of the included literature was evaluated by referring to the evaluation criteria for randomized controlled trials provided in the Cochrane Systematic Evaluation Manual.Results:Six randomized controlled trials studies were included,all of which were Chinese literature.Five of them had 4 or more points in methodological quality evaluation and one had 3 points in methodology quality evaluation.There were 525 patients in the two groups,267 in the PKP group and 258 in the conservative treatment group.Meta-analysis showed that the pain visual analogue score in the PKP group was significantly higher than that in the conservative treatment group[MD=2.10,95%CI(-2.25,-1.95),P<0.00001].There were significant differences between the PKP group and the conservative treatment(CT)group[MD=8.90,95%CI(-9.86,-7.94),P<0.00001]in the changes of the Cobb angle of the diseased vertebrae after treatment.There were significant differences in the ODI and the height of the anterior edge of the diseased vertebrae(P<0.05).Conclusion:PKP treatment of OVCF can effectively reduce pain visual analogue score,improve dysfunction index(ODI)and improve the quality of life of patients.It can also effectively restore the height of vertebral loss,correct the Cobb angle of the diseased vertebrae,and reduce the risk of recurrent fracture of the adjacent vertebral body and serious complications.展开更多
文摘目的:观察经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)联合鲑鱼降钙素治疗老年骨质疏松性椎体压缩骨折的疗效。方法:患者行PKP术后随机分为两组:对照组每日口服碳酸钙D3;治疗组术后予以鲑鱼降钙素和碳酸钙D3联合治疗。分别在术前、术后3d及6个月采用疼痛视觉模拟评分(visual analog scale,VAS)评分、活动能力评分及术后6个月患者伤椎高度丢失、邻近椎体骨折情况来评估两组治疗效果。结果:两组患者术后疼痛均有明显缓解,但与对照组相比,治疗组在术后6个月VAS评分和活动能力评分降低更为明显,患者伤椎高度丢失明显减轻,邻近椎体骨折显著减少,且差异有统计学意义(P均<0.05)。结论:PKP联合鲑鱼降钙素治疗骨质疏松性椎体压缩骨折在缓解疼痛、增强活动能力、减少伤椎高度丢失和邻近椎体骨折方面具有更好的疗效,值得临床推广。
文摘<strong>Background:</strong> Zoledronic acid and teriparatide have been proved to be effective in improving bone metabolism and preventing fractures, but there is no clear clinical report on the efficacy of their combined application. <strong>Purpose:</strong> To discuss the clinical effect of zoledronic acid combined with teriparatide in perverting recurrent fracture of osteoporotic vertebral compressive fractures (OVCF) in the elderly after percutaneous kyphoplasty (PKP). <strong>Method:</strong> A randomized clinical trial was conducted at the First Affiliated Hospital of Hebei North University in China from September 2018 and September 2019. A total of 60 patients with OVCF were enrolled in the study (zoledronic acid: 20 cases;teriparatide: 20 cases;zoledronic acid + teriparatide: 20 cases). Observe and compare the changes of bone mineral density (BMD), pro-collagen type I N-terminal propeptide (PINP) and cross-linked C-terminal telopeptide of type I collagen (<em>β</em>-CTX) before surgery, 6 months and 1 year after surgery. At the same time, secondary fracture events and adverse reaction events were recorded during the follow-up period. <strong>Results:</strong> After normalized treatment, the bone metabolism indexes of PINP and <em>β</em>-CTX were improved and BMD was increased in three groups. <strong>Adverse Reactions:</strong> There was no statistical significance in the incidence of fever, gastrointestinal reactions and myalgia among the three groups (P > 0.05). The incidence of recurrent fractures in group A was higher than that in group C (P < 0.05), but there was no significant difference between group B and group C (P > 0.05). <strong>Conclusion:</strong> Zoledronic acid combined with teriparatide is superior to Zoledronic acid in preventing the risk of recurrent fracture after PKP for old patients with OVCF, but it has no significant advantage over teriparatide.
基金National Natural Science Foundation of China(81674005)Fundamental Research Funds for the Central public welfare research institutes(ZZ10-015)Capital Health Research and Development of Special(2018-2-4162).
文摘Objective:To evaluate the clinical efficacy of percutaneous kyphoplasty(PKP)in the treatment of osteoporotic vertebral compression fractures(OVCF)in the elderly by meta-analysis,and to provide a basis for clinical application.Methods:CNKI,Wanfang,Weipu,CBM,PubMed,the Cochrane Library and EMbase were retrieved by computer from the date of establishment to January 2019.The literature on randomized controlled trials of PKP and conservative treatment of OVCF was collected and diagnosed as thoracolumbar vertebral compression fracture by X-ray,CT,and MRI.Osteoporosis of thoracolumbar vertebrae(T<2.5)was determined by bone mineral density measurements.Age(>50 years old)and course of the disease(<3 months).Postoperative outcome indicators included at least one of the following indicators:visual analogue scale.VAS and Oswestry Dysfunction Index(ODI),changes of Cobb angle of diseased vertebrae and height of the anterior edge of diseased vertebrae.The quality of the included literature was evaluated by referring to the evaluation criteria for randomized controlled trials provided in the Cochrane Systematic Evaluation Manual.Results:Six randomized controlled trials studies were included,all of which were Chinese literature.Five of them had 4 or more points in methodological quality evaluation and one had 3 points in methodology quality evaluation.There were 525 patients in the two groups,267 in the PKP group and 258 in the conservative treatment group.Meta-analysis showed that the pain visual analogue score in the PKP group was significantly higher than that in the conservative treatment group[MD=2.10,95%CI(-2.25,-1.95),P<0.00001].There were significant differences between the PKP group and the conservative treatment(CT)group[MD=8.90,95%CI(-9.86,-7.94),P<0.00001]in the changes of the Cobb angle of the diseased vertebrae after treatment.There were significant differences in the ODI and the height of the anterior edge of the diseased vertebrae(P<0.05).Conclusion:PKP treatment of OVCF can effectively reduce pain visual analogue score,improve dysfunction index(ODI)and improve the quality of life of patients.It can also effectively restore the height of vertebral loss,correct the Cobb angle of the diseased vertebrae,and reduce the risk of recurrent fracture of the adjacent vertebral body and serious complications.
