小剂量骨水泥椎体后凸成形联合唑来膦酸治疗骨质疏松椎体压缩性骨折

发布时间：2018-10-11 08:19

【摘要】：背景:经皮椎体后凸成形治疗骨质疏松性压缩骨折的效果已获肯定,但仍旧存在骨水泥漏、再骨折等相关并发症,缺乏骨质疏松的后期治疗。目的:探讨临床小剂量骨水泥椎体后凸成形联合唑来膦酸治疗骨质疏松椎体压缩性骨折后的骨密度、椎体高度及腰背痛疼痛改善情况。方法:将80例骨质疏松椎体压缩性骨折患者随机分2组治疗,试验组(n=40)进行小剂量骨水泥椎体后凸成形联合唑来膦酸治疗,对照组(n=40)进行常规剂量骨水泥椎体后凸成形治疗,记录治疗前、治疗后3 d及末次随访的目测类比评分、椎体高度和Cobb角改善情况,治疗后1年复查骨密度及再发骨折情况。结果与结论:(1)目测类比评分:两组治疗3 d、末次随访的目测类比评分均显著低于治疗前(P0.05),两组间比较差异无显著性意义;(2)椎体高度和Cobb角:两组治疗3 d、末次随访的椎体高度和Cobb角均较治疗前明显改善(P0.05),两组间比较差异无显著性意义;(3)骨密度:试验组治疗后1年的骨密度明显高于治疗前(P0.05),对照组治疗前后无明显变化;(4)再发骨折情况:试验组1例出现邻近椎体骨折,对照组5例出现邻近椎体骨折;(5)结果表明:小剂量骨水泥椎体后凸成形联合唑来膦酸治疗骨质疏松椎体压缩性骨折在有效缓解疼痛、恢复椎体高度的同时可显著提高骨密度,减少相邻节段骨折的发生。
[Abstract]:Background: the effect of percutaneous vertebra kyphoplasty in the treatment of osteoporotic compression fractures has been confirmed, but there are still some related complications, such as bone cement leakage, refracture and so on. Objective: to investigate the improvement of bone mineral density (BMD), vertebral height and low back pain after low dose bone cement kyphoplasty combined with zoledronic acid in the treatment of osteoporotic vertebral compression fracture. Methods: 80 patients with osteoporotic vertebral compression fracture were randomly divided into two groups: the experimental group (n = 40) was treated with low dose bone cement kyphoplasty combined with zoledronic acid, and the control group (n = 40) was treated with conventional dose bone cement kyphoplasty. The visual analogue score, vertebral height and Cobb angle were recorded before, 3 days and 3 days after treatment. The bone mineral density (BMD) and recurrent fracture were reexamined 1 year after treatment. Results and conclusion: (1) Visual analogue score: the visual analogue scores of the two groups were significantly lower than those before treatment for 3 days and the last follow-up (P0.05), and there was no significant difference between the two groups; (2) vertebral height and Cobb angle: the two groups were treated for 3 days and the last time followed by the treatment. The vertebral height and Cobb angle were significantly improved (P0.05), and there was no significant difference between the two groups. (3) BMD: the BMD in the experimental group was significantly higher than that before treatment (P0.05), and there was no significant change in the control group before and after treatment. Recurrent fracture: one case of adjacent vertebral body fracture occurred in the experimental group, The results showed that low dose bone cement kyphoplasty combined with zoledronic acid in the treatment of osteoporotic vertebral compression fracture could effectively relieve the pain and restore the height of vertebral body. Reduce the incidence of adjacent segment fractures.
【作者单位】：珠海市人民医院脊柱骨病科;
【分类号】：R687.3

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