Three-year clinical observation for treating aged vertebral compression fractures combined vertebral plasty with anti-osteoporotic drug

doi:10.3877/cma.j.issn.1674-134X.2018.03.025

Abstract

Abstract:

Objective

To observe the clinical curative effect of treatment for senile vertebral compression fractures by vertebral plasty combine with anti-osteoporosis drug for three years.

Methods

From January 2013 to January 2015, 525 cases of aged vertebral compression fractures were observed, among which 412 were females, 113 were males; aged from 64 to 91 years, the average age was (79±11) years. All the patients accepted percutaneous vertebral plasty surgery guided by CT and C arm X ray, anti-osteoporotic drugs were administrated which included diphosphonate by intravenous infusion in postoperative 2~4 d, calcium, vitamin D and vitamin K2 supplements. The lower back pain visual analogue scale (VAS) and Oswestry disability index (ODI) were recorded preoperatively, one week postoperatively and at the last follow-up.Bone mineral density and bone metabolism index were recorded preoperatively and at the postoperative three-year follow-up. Paired t test was used to analyze the data of each group obtained at different time after the surgery and before the surgery.

Results

There were 189 (36%) patients came back for one year follow-up, 131 (25%) for two-year follow-up, only 56 patients (10.7%) insisted three-year follow-up. Among these 56 patients, 17 cases occurred vertebral fracture again. After three-year follow-up, the lower back pain VAS score(t=3.01), ODI score(t=0.98), bone mineral density improved compared with preoperative ones, and the differences were statistically significant (P<0.05). As for the bone metabolism index, the osteocalcin (OC) increased(t=5.75) and the β-CTX decreased(t=3.06) compared with preoperative ones, the differences were significant statistically (P<0.05), while the other indicators showed no statistical difference.

Conclusions

For the long-term follow-up, the treatment compliance of senile patients with vertebral compression fractures is not optimistic. After three-year treatment of vertebral plasty combined with anti-osteoporotic drug for aged vertebral compression fractures patient, the treatment can obviously relieve patients' clinical symptoms, improve quality of life, promote bone formation, inhibit bone resorption and improve bone mineral density.

Key words: Osteoporosis, Bone density, Drug therapy, Osteoporotic fractures, Vertebroplasty

Chengyi Zhao, Qing Li, Daochen Liang, Aiming Zhang, Zhi Mei, Haiyan Yao, Zhidan Fan, Yingchao Chen. Three-year clinical observation for treating aged vertebral compression fractures combined vertebral plasty with anti-osteoporotic drug[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2018, 12(03): 433-437.

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References 12

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?	?	VAS	?	?	ODI(%)	?
术前	?	7.6±1.1	?	?	72.6±7.5	?
术后1周	?	3.7±0.6	?	?	33.7±9.2	?
术后3年	?	2.7±1.0	?	?	41.3±10.9	?
t值	2.24^a	3.01^b	0.48^c	0.47^a	0.98^b	0.84^c
P值	<0.05^a	<0.05^b	>0.05^c	<0.05^a	<0.05^b	>0.05 ^c

?	?	VAS	?	?	ODI(%)	?
术前	?	7.6±1.1	?	?	72.6±7.5	?
术后1周	?	3.7±0.6	?	?	33.7±9.2	?
术后3年	?	2.7±1.0	?	?	41.3±10.9	?
t值	2.24^a	3.01^b	0.48^c	0.47^a	0.98^b	0.84^c
P值	<0.05^a	<0.05^b	>0.05^c	<0.05^a	<0.05^b	>0.05 ^c

?	骨密度(T值)			骨代谢指标
?	腰椎	左股骨近端	右股骨近端	OC(ng/ml)	β-CTX(pg/ml)	VD(ng/ml)	PINP(ng/ml)	PTH(pg/ml)
术前	－2.8±1.3	－2.2±1.0	－2.1±1.0	12.3±5.1	307.3±226.0	31.0±13.7	31.1±13.7	41.2±15.8
术后3年	－2.6±1.4	－1.9±1.0	－1.9±1.0	22.4±4.1	173.8±64.3	29.3±9.3	29.3±14.0	39.0±13.5
t值	5.54	3.74	2.30	5.75	3.06	0.54	0.49	0.57
P值	<0.05	<0.05	<0.05	<0.05	<0.05	>0.05	>0.05	>0.05

?	骨密度(T值)			骨代谢指标
?	腰椎	左股骨近端	右股骨近端	OC(ng/ml)	β-CTX(pg/ml)	VD(ng/ml)	PINP(ng/ml)	PTH(pg/ml)
术前	－2.8±1.3	－2.2±1.0	－2.1±1.0	12.3±5.1	307.3±226.0	31.0±13.7	31.1±13.7	41.2±15.8
术后3年	－2.6±1.4	－1.9±1.0	－1.9±1.0	22.4±4.1	173.8±64.3	29.3±9.3	29.3±14.0	39.0±13.5
t值	5.54	3.74	2.30	5.75	3.06	0.54	0.49	0.57
P值	<0.05	<0.05	<0.05	<0.05	<0.05	>0.05	>0.05	>0.05

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