胸腰椎经皮椎体后凸成形后连续2年应用唑来膦酸预防二次骨折

发布时间：2018-08-26 13:34

【摘要】：背景:研究表明,老年骨质疏松性胸腰椎骨折经皮椎体后凸成形后未行抗骨质疏松治疗,导致其他椎体由于骨密度降低和应力的改变出现二次骨折的发生。目的:分析经皮椎体后凸成形后连续2年应用唑来膦酸预防术后椎体继发骨折的可行性。方法:胸腰椎压缩性骨折老年患者186例经皮椎体后凸成形后根据是否自愿应用唑来膦酸分为试验组(84例)和对照组(102例),对照组给予钙剂及阿法骨化醇治疗,试验组在常规给予钙剂、阿法骨化醇后给予连续2年唑来膦酸治疗。所有患者分别于治疗前及第2次注射唑来膦酸治疗后第2年采用双能X射线吸收法、目测类比评分、Oswestry功能障碍指数(ODI)进行骨密度、疼痛和功能评估,并统计2组再骨折数量。结果与结论:(1)2组用药2年后Oswestry功能障碍指数评分、骨密度、目测类比评分均显著优于治疗前(P0.05);(2)试验组2年内有1例再骨折发生,对照组有9例再骨折发生,2组比较差异有显著性意义(P0.05)。(3)结果说明,应用唑来膦酸可以预防老年胸腰椎脆性骨折椎体后凸成形后二次骨折发生,提高远期功能及临床疗效。
[Abstract]:Background: studies have shown that patients with osteoporotic thoracolumbar fractures do not undergo anti-osteoporosis treatment after percutaneous kyphoplasty, which leads to secondary fractures in other vertebrae due to reduced bone mineral density and stress changes. Objective: to analyze the feasibility of zoledronic acid in preventing secondary vertebral fracture after percutaneous kyphoplasty for 2 years. Methods: 186 elderly patients with thoracolumbar vertebral compression fracture were divided into experimental group (84 cases) and control group (102 cases) according to the voluntary application of zoledronic acid after percutaneous vertebra kyphoplasty. The trial group was treated with zoledronic acid for 2 years after routine administration of calcium and alfacalciol. Before and after the second injection of zoledronic acid, the bone mineral density (BMD), pain and function of the two groups were evaluated by visual analogue score and Oswestry dysfunction index (ODI), and the number of refractures in the two groups was counted. Results and conclusion: (1) the scores of Oswestry dysfunction index, bone mineral density and visual analogy were significantly better in two groups than before treatment (P0.05); (2). The results showed that zoledronic acid could prevent the secondary fracture after kyphoplasty of thoracolumbar brittle fracture and improve the long-term function and clinical effect in the control group (P0.05). (3).
【作者单位】：大连市第二人民医院骨科;
【基金】：辽宁省博士科研启动基金项目(2013ED15F167)~~
【分类号】：R687.3

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