Department of Orthopedics, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, Guangdong Province, China.
Department of Gynaecology and Obstetrics, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, Guangdong Province, China.
J Orthop Surg Res. 2019 Dec 18;14(1):452. doi: 10.1186/s13018-019-1499-9.
The purpose of this study is to explore the therapeutic effect of percutaneous kyphoplasty (PKP) combined with anti-osteoporosis drug, zoledronic acid, on postmenopausal women with osteoporotic vertebral compression fracture (OVCF) and to perform an analysis of postoperative bone cement leakage risk factors.
A total of 112 OVCF patients, according to therapeutic regimens, were divided into control group (n = 52, treated with PKP) and observation group (n = 60, treated with PKP and zoledronic acid injection).
Postoperative tumor necrosis factor-α and interleukin-6 levels were significantly decreased in the two groups, compared with those before treatment (both P < 0.05); bone mineral density (BMD), serum bone gla protein (BGP), and vertebral height ratio of injured vertebrae were significantly increased, and procollagen type I N-terminal propeptide (PINP), Cobb angle, visual analogue scale/score (VAS), and Oswestry disability index (ODI) were significantly decreased compared with those before treatment (all P < 0.05). There were significantly higher changes in difference value of BMD, PINP, BGP, vertebral height ratio of injured vertebrae, Cobb angle, VAS, and ODI levels and significantly better therapeutic effect in the observation group than those in the control group (all P < 0.05). Multivariate logistic regression analysis showed that the use of zoledronic acid, vertebral height ratio of injured vertebrae, and ODI were independent factors affecting the therapeutic effect, and that the dosage of bone cement, and peripheral vertebrae wall damage were independent risk factors causing postoperative bone cement leakage. There were no significant differences in postoperative bone cement leakage rate between the two groups.
Peripheral vertebrae wall damage and the dosage of bone cement are independent risk factors causing bone cement leakage in OVCF patients treated with PKP. PKP combined with zoledronic acid has an improvement effect on the condition of postmenopausal women with OVCF and reduces the inflammation and pain in patients, which is beneficial to clinical treatment.
本研究旨在探讨经皮椎体后凸成形术（PKP）联合唑来膦酸抗骨质疏松药物治疗绝经后骨质疏松性椎体压缩性骨折（OVCF）的疗效，并对术后骨水泥渗漏的危险因素进行分析。
将 112 例 OVCF 患者根据治疗方案分为对照组（n=52，行 PKP 治疗）和观察组（n=60，行 PKP 联合唑来膦酸注射液治疗）。
两组术后肿瘤坏死因子-α、白细胞介素-6 水平均较治疗前降低（均 P＜0.05）；骨密度（BMD）、血清骨钙素（BGP）、伤椎椎体高度比值均较治疗前升高，而Ⅰ型前胶原氨基端前肽（PINP）、Cobb 角、视觉模拟评分/量表（VAS）、Oswestry 功能障碍指数（ODI）较治疗前降低（均 P＜0.05）；观察组 BMD、PINP、BGP、伤椎椎体高度比值、Cobb 角、VAS、ODI 差值水平变化的绝对值更高，疗效更佳（均 P＜0.05）。多因素 Logistic 回归分析显示，唑来膦酸的使用、伤椎椎体高度比值、ODI 是影响疗效的独立因素，骨水泥用量、外周椎体壁损伤是引起术后骨水泥渗漏的独立危险因素。两组术后骨水泥渗漏率比较差异无统计学意义。
PKP 治疗 OVCF 患者，外周椎体壁损伤和骨水泥用量是引起术后骨水泥渗漏的独立危险因素，PKP 联合唑来膦酸治疗绝经后 OVCF 患者，可改善患者病情，减轻患者炎症和疼痛，有利于临床治疗。
