【摘要】：背景:經皮椎體后凸成形治療骨質疏松性壓縮骨折的效果已獲肯定,但仍舊存在骨水泥漏、再骨折等相關并發(fā)癥,缺乏骨質疏松的后期治療。目的:探討臨床小劑量骨水泥椎體后凸成形聯(lián)合唑來膦酸治療骨質疏松椎體壓縮性骨折后的骨密度、椎體高度及腰背痛疼痛改善情況。方法:將80例骨質疏松椎體壓縮性骨折患者隨機分2組治療,試驗組(n=40)進行小劑量骨水泥椎體后凸成形聯(lián)合唑來膦酸治療,對照組(n=40)進行常規(guī)劑量骨水泥椎體后凸成形治療,記錄治療前、治療后3 d及末次隨訪的目測類比評分、椎體高度和Cobb角改善情況,治療后1年復查骨密度及再發(fā)骨折情況。結果與結論:(1)目測類比評分:兩組治療3 d、末次隨訪的目測類比評分均顯著低于治療前(P0.05),兩組間比較差異無顯著性意義;(2)椎體高度和Cobb角:兩組治療3 d、末次隨訪的椎體高度和Cobb角均較治療前明顯改善(P0.05),兩組間比較差異無顯著性意義;(3)骨密度:試驗組治療后1年的骨密度明顯高于治療前(P0.05),對照組治療前后無明顯變化;(4)再發(fā)骨折情況:試驗組1例出現(xiàn)鄰近椎體骨折,對照組5例出現(xiàn)鄰近椎體骨折;(5)結果表明:小劑量骨水泥椎體后凸成形聯(lián)合唑來膦酸治療骨質疏松椎體壓縮性骨折在有效緩解疼痛、恢復椎體高度的同時可顯著提高骨密度,減少相鄰節(jié)段骨折的發(fā)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.
【作者單位】： 珠海市人民醫(yī)院脊柱骨病科;
【分類號】：R687.3

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