Department of Orthopedic Surgery, Spine Section, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Eur Spine J. 2024 Aug;33(8):3284-3290. doi: 10.1007/s00586-024-08349-9. Epub 2024 Jun 27.
To investigate efficacy of 3-month teriparatide(TPD) and compare this treatment with vertebroplasty in terms of clinical and radiographic outcomes after osteoporotic vertebral compression fractures (OVCFs).
This is a retrospective matched cohort study. Patients who received conservative treatment with at least 3-month TPD treatment for acute OVCF with at least 6 months follow-up were included. Each enrolled TPD case was matched with 2 vertebroplasty cases using age and gender. 30 TPD cases and 60 vertebroplasty cases were enrolled. Patient-reported pain scores were obtained at diagnosis and 1, 3, 6 months after diagnosis. Radiographic parameters including middle body height, posterior body height, wedge angle and kyphotic angle were measured at diagnosis and 6 months after diagnosis. Fracture non-union and subsequent vertebral fracture were evaluated.
TPD treatment showed inferior pain relief to vertebroplasty group at 1 month, but did not show difference at 3 and 6 months after diagnosis. In TPD cases, progression of vertebral body collapse was noted in terms of middle body height and wedge angle at final follow up. Instead, both middle body height and wedge angle increased significantly after operation in the vertebroplasty group. Fracture non-union was confirmed via MRI and 4 TPD patients were diagnosed with non-union (4/30, 13.3%). Subsequent compression fracture within 6 months was significant higher in vertebroplasty group (12/60, 20%) than in TPD group (1/30, 3.3%).
In acute OVCFs, 3-month TPD treatment alone showed comparable pain improvement and less subsequent spine fracture than vertebroplasty.
研究 3 个月特立帕肽（TPD）的疗效，并将其与椎体成形术在骨质疏松性椎体压缩性骨折（OVCF）后的临床和影像学结果方面进行比较。
这是一项回顾性匹配队列研究。纳入至少接受 3 个月 TPD 治疗急性 OVCF 且至少随访 6 个月的患者。每位入组的 TPD 病例均按年龄和性别与 2 例椎体成形术病例匹配。共纳入 30 例 TPD 病例和 60 例椎体成形术病例。在诊断时和诊断后 1、3、6 个月测量患者报告的疼痛评分。在诊断时和诊断后 6 个月测量中间体高度、后体高度、楔角和后凸角等影像学参数。评估骨折不愈合和随后的椎体骨折。
TPD 治疗在 1 个月时的止痛效果不如椎体成形术组，但在诊断后 3 个月和 6 个月时无差异。在 TPD 病例中，终末随访时中间体高度和楔角均显示椎体塌陷进展。相反，椎体成形术组术后中间体高度和楔角均显著增加。通过 MRI 证实骨折不愈合，4 例 TPD 患者诊断为不愈合（4/30，13.3%）。椎体成形术组在 6 个月内发生后续压缩骨折的比例显著高于 TPD 组（12/60，20%）。
在急性 OVCF 中，单独使用 3 个月 TPD 治疗在疼痛改善和随后的脊柱骨折方面与椎体成形术相当。
