经皮椎体成形术对老年骨质疏松椎体压缩性骨折患者疼痛程度、关节功能的影响

目的分析经皮椎体成形术(PVP)对老年骨质疏松椎体压缩性骨折(OVCF)患者疼痛程度、关节功能的影响。方法选择2012年8月至2014年8月在该院接受治疗的老年OVCF患者68例,根据治疗方式分为观察组30例和对照组38例,观察组接受PVP治疗,对照组接受保守治疗。比较两组患者的疼痛程度、关节功能及治疗效果。结果观察组优良率明显高于对照组(χ2=5.382,P0.05);治疗后3 d及3个月时,观察组患者视觉疼痛评分(VAS)及功能障碍指数(ODI)均低于对照组(P0.05);术后观察组患者压缩椎体的前缘、中央及后缘高度明显高于对照组(P0.05)。结论 PVP可用于老年OVCF患者的治疗,可以有效减轻患者的疼痛感受,优化关节功能,提高压缩椎体的高度。     

血清N-MID、BMP-7水平与骨质疏松性椎体压缩性骨折术后骨折延迟愈合的关系

目的 探讨血清骨钙素N端中分子片段(N-MID)、骨形态发生蛋白7(BMP-7)水平与骨质疏松性椎体压缩性骨折(OVCF)术后骨折延迟愈合的关系.方法 选择接受经皮椎体成形术治疗的OVCF患者254例,术后12周出现骨折延迟愈合20例(观察组)、未出现骨折延迟愈合234例(对照组).术后12周,采集空腹肘静脉血,离心留...     

弯角式椎体成形套管在老年骨质疏松椎骨压缩性骨折中的应用

目的对比弯角式椎体成形套管与传统直口式椎体成形套管在老年骨质疏松椎骨压缩性骨折(OVCF)治疗中的疗效。方法 36例老年OVCF患者给予经皮椎体成形术治疗,观察组术中采用弯角式椎体成形套管,对照组采用传统直口式椎体成形套管,对比两组手术前后临床症状缓解情况,不同椎体成形套管对患者手术时间及住院天数的影响。结果观察组手术时间明显短于对照组(P0.05),两组住院天数差异无统计学意义(P0.05);观察组发生骨水泥渗漏并发症的发生率明显低于对照组(P0.05);两组术前视觉模拟评分(VAS)均明显高于术后2 d(P0.05);两组术前和术后2 d VAS差异无统计学意义(P0.05)。结论弯角式椎体成形套管可以明显缩短OVCF患者手术时间,减少骨水泥渗漏发生率。     

依降钙素配合经皮球囊扩张椎体后凸成形术治疗绝经后妇女骨质疏松性椎体压缩骨折早期临床疗效

目的观察依降钙素配合经皮球囊扩张椎体后凸成形术(PKP)治疗绝经后妇女骨质疏松性椎体压缩骨折(OVCF)早期临床效果。方法因OVCF行PKP的绝经后妇女随机分为观察组(68例,PKP术后当日给予依降钙素肌注)及对照组(68例,单纯予PKP)。患者均进行不少于半年的随访,平均随访时间(7.21±0.43)个月,分别记录两组术前、术后3 d、1个月、3个月、末次随访时视觉模拟疼痛评分(VAS)、Oswestry功能障碍指数(ODI)及术前、术后3个月、末次随访时骨密度(BMD)等相关数据并进行对比分析。结果所有手术均顺利完成,两组患者术后腰背部疼痛及功能障碍均有效缓解,与对照组相比,观察组在术后1、3个月、末次随访时缓解更加明显。至末次随访时对照组术后新发邻近椎体骨折2例,手术椎体再骨折6例;观察组术后发生邻近椎体骨折1例,手术椎体再骨折1例,两组骨折发生时间集中在术后(4.5±0.57)个月,两组早期术后再骨折总发生率比较差异有统计学意义(P0.05)。结论 PKP治疗绝经后妇女OVCF临床疗效显著,术后给予依降钙素肌注可减轻因骨质疏松进行性加重导致的腰背痛,并能有效降低早期再骨折的发生率。     

老年骨质疏松性椎体压缩性骨折患者急性期MRI信号与经皮椎体后凸成形术后效果的相关性

目的分析老年骨质疏松性椎体压缩性骨折(OVCF)患者急性期MRI信号与经皮椎体后凸成形术(PKP)后效果的相关性。方法收集行PKP治疗的急性期单节段老年OVCF患者98例。根据患者术前MRI中T2WI信号强度将其分为低信号组(A组)、中低信号组(B组)、中等信号组(C组)及中高信号组(D组)。比较4组术前、术后疼痛情况,椎体凸Cobb角、高度及压缩率的变化情况及其相关性。结果各组患者术后视觉模拟评分(VAS)、椎体凸Cobb角、高度及压缩率较术前均有明显程度的改善,差异有统计学意义(P0.05)。术前及术后上述各因素在组间进行比较,差异无统计学意义(P0.05)。MRI信号强度与上述因素不存在相关性(r=1.46,P=0.12)。结论老年OVCF患者急性期MRI信号与PKP后效果无明显相关性,但PKP对OVCF的治疗效果显著。     

双侧经皮椎体成形术后相邻椎体骨折列线图预测模型构建

目的 探讨骨质疏松性椎体压缩骨折（OVCF）患者行双侧经皮椎体成形术（PVP）后相邻椎体骨折的影响因素,并构建列线图预测模型。方法 选取2019年8月—2022年8月广西中医药大学第一附属医院脊柱外科收治的174例行双侧PVP的OVCF患者。根据术后是否新发生相邻椎体骨折分为相邻椎体骨折者与未骨折者。采用LASSO回归法和二元logistic回归分析OVCF患者双侧PVP后相邻椎体骨折的危险因素,应用R Studio构建列线图预测模型,并对其预测效能进行评价。结果 OVCF患者双侧PVP后相邻椎体骨折47例,未骨折127例。LASSO回归与二元Logistic回归分析结果显示,BMI、术前椎体压缩比、术后椎体恢复比、伤椎Cobb角矫正度、腰椎骨密度、骨水泥渗漏是OVCF患者双侧PVP后相邻椎体骨折的影响因素。采用上述6个影响因素成功构建列线图预测模型,该模型预测OVCF患者双侧PVP后相邻椎体骨折的受试者工作特征曲线下面积为0.838(95%CI:0.679～0.875)。Boostrap法对模型内部进行验证,结果显示该模型预测与实际情况较为一致（C-index为0.838）。结论 骨...     

绝经后妇女骨质疏松性压缩骨折PVP、PKP治疗效果及优劣势比较

目的分析经皮椎体后凸成形术(PKP)与经皮椎体成形术(PVP)治疗绝经后妇女骨质疏松性椎体压缩骨折(OVCF)的临床效果及其优劣势。方法选择绝经后女性OVCF患者42例,采用随机数字表法分为PKP组与PVP组,每组21例。分析两组患者在术前、术后2 w、术后6个月的椎体前后缘高度及脊柱后突Cobb角度、骨密度及生存质量情况。结果PKP组的骨水泥量、术中透视次数显著多于PVP组,手术时间显著长于PVP组,抗骨质疏松治疗时间显著短于PVP组(均P<0.05),而两组的手术切口长度比较无统计学意义(P>0.05)。术前,两组的椎体前后缘高度、椎体后突Cobb角度比较无统计学意义(P>0.05);术后,两组以上椎体参数均显著改善(P<0.05),且PKP组在术后2 w、术后6个月以上椎体参数改善效果显著优于PVP组(P<0.05)。术后6个月,PKP组股骨颈与下腰椎骨密度均明显大于PVP组(P<0.05)。术后6个月,两组各项生存质量指标评分均显著提高(P<0.05),且PKP组的以上指标评分均显著高于PVP组(P<0.05)。PKP组发生骨水泥渗漏1例(4.76%),明显低于PVP组4例(19.05%,P<0.05)。结论PKP术治疗绝经后妇女OVCF的临床效果优于PVP术,有助于椎体骨密度增加,快速恢复脊椎功能,改善患者的生活质量。     

经皮椎体成形术和经皮椎体后凸成形术治疗老年女性胸腰椎移行处单椎体骨质疏松性压缩性骨折对邻接椎体骨密度的影响

目的观察经皮椎体成形术(PVP)和经皮椎体后凸成形术(PKP)治疗绝经后女性胸腰椎移行处(T12/L1段)单椎体骨质疏松性压缩性骨折术后邻接椎体骨密度(BMD)的影响。方法 2008年1月至2011年6月收治绝经后女性胸腰椎移行处单椎体骨质疏松性压缩性骨折患者50例,根据手术方法不同随机分为PVP组(25例)和PKP组(25例)。于术前、术后1 w和随访时行视觉模拟评分(VAS)、Owestry评分和伤椎后凸角测量;并于于其围术期和术后达一年以上测量其手术椎体上下各一个椎体的BMD值。结果术后随访12⁴8个月,平均(25.46±7.84)个月。两组患者临床症状得以显著改善,PKP组在脊柱后凸角的纠正和脊柱矢状序列维持方面优于PVP组。两组围手术期、随访时上一椎体BMD无明显差异(P>0.05),下一椎体存在显著差异(P<0.05)。两组间上一椎体围术期、随访时BMD无显著差异(P>0.05)。下一椎体围术期没有显著差异(P>0.05);随访时存在显著差异(P<0.05)。结论 PVP和PKP术是治疗老年女性胸腰椎移行处单椎体OVCF临床疗效显著。经PVP和PKP治疗老年女性胸腰椎移行处单椎体OVCF患者,术后1年以上手术椎体的下一椎体BMD增加提高了其椎体强度,使下一椎体骨折发生率得以降低,且PKP相对于PVP更有助于提高下一椎体BMD。     

强化平衡训练在骨质疏松椎体压缩性骨折患者术后康复中的应用

目的 观察强化平衡训练在骨质疏松椎体压缩性骨折（OVCF）患者术后康复中的应用效果。方法 80例行椎体成形术治疗的OVCF患者按照术后康复方法不同分为观察组和对照组各40例，对照组采用药物治疗和常规康复训练，观察组在对照组治疗基础上增加强化平衡训练，两组均康复治疗4周，比较两组不同时点Berg平衡量表评分、重心摆动轨迹长（SL）、外周面积（SA）、Oswestry功能障碍指数（ODI）评分、VAS评分、骨密度及术后1年跌倒、二次骨折情况。结果 与同组训练前比较，两组训练4周和术后1年Berg平衡量表评分增加，SL、SA、ODI评分、VAS评分减小（P均<0.05）；与对照组比较，观察组训练4周和术后1年Berg平衡量表评分增加，SL、SA、ODI评分减小（P均<0.05）。与同组训练前比较，两组术后1年骨密度增加（P均<0.05）。观察组术后1年0次跌倒25例、1次跌倒10例、2次跌倒4例、≥3次跌倒1例，对照组分别为14、16、7、3例，两组跌倒次数比较，P<0.05；观察组及对照组术后1年发生二次骨折2例（5%）、8例（20%），两组比较，P<0.05...     

经皮椎体后凸成形术治疗高龄骨质疏松性椎体压缩骨折

经皮椎体后凸成形术(PKP)是治疗骨质疏松性椎体压缩骨折(OVCF)的理想术式,具有微创,迅速缓解疼痛,改善后凸畸形及骨水泥渗漏率低等优点〔1〕。本文回顾分析PKP治疗高龄(>80岁)OVCF患者的临床疗效。1资料与方法1.1对象2007年8月至2009年2月我科收治的高龄OVCF患者57例,其中男13例,女44例;年龄80~92〔平均(83.7±     

整脊推拿手法联合针刺治疗腰椎间盘突出症的疗效观察

目的 观察整脊推拿手法联合针刺治疗腰椎间盘突出症(LDH)的疗效。方法 选择中山市中医院2018年5月至2021年3月收治的LDH患者90例,采用随机数字表法将其分为观察组和对照组,每组45例。对照组采用整脊推拿手法治疗,观察组采用整脊推拿手法联合针刺治疗,两组疗程均为4周。比较两组临床疗效,治疗前后日本骨科协会(JOA)评分、视觉模拟量表(VAS)评分、生活质量评分,以及腰椎伸直过程、屈曲过程的平均表面肌电值(AEMG)。结果 观察组临床总有效率高于对照组,差异有统计学意义(95.56%vs80.00%;χ²=5.075,P=0.024)。治疗后,两组JOA、SF-36评分均升高,VAS评分降低,与同组治疗前比较差异有统计学意义(P <0.05),且观察组变化较对照组更显著(P <0.05)。治疗后两组腰椎伸直过程的AEMG均升高,屈曲过程的AEMG均降低,与同组治疗前比较差异有统计学意义(P <0.05),且观察组变化较对照组更显著(P <0.05)。结论 整脊推拿手法联合针刺治疗LDH可促进疼痛缓解,改善腰背肌力学效应和腰椎功能,提高...     

骨水泥倒U型分布对经皮椎体成形术治疗骨质疏松椎体压缩性骨折效果的影响

目的探讨经皮椎体成形术(percutaneous vertebroplasty,PVP)中骨水泥倒U型注射分布对治疗骨质疏松性椎体压缩性骨折(osteoporosis vertebral compression fracture,OVCF)临床治疗效果的影响.方法回顾性研究2014年7月至2018年6月因住院并行PVP治疗的70例患者,男性10例,女性60例;年龄60~87岁,平均年龄(73.02±7.74)岁;病程3h^2个月,平均病程(15.35±5.45)d.根据CT检查明确骨水泥的分布情况,依次将患者分为骨水泥呈"倒U型"弥散分布组和骨水泥不规则弥散组.记录术前、术后3 d,3、6个月及1年时的疼痛视觉模拟评分(visual analogue scale,VAS)、椎体高度(body height,BH)及局部后凸Cobb角,对比分析两组上述指标的差异,并记录相关并发症.结果两组患者术前基线特征比较差异无统计学意义(P>0.05),术后VAS较术前均明显降低(P<0.05),倒U型分布组由术前的(7.4±0.8)分降低至术后第3天的(2.5±0.6)分,不规则分布组由(7.5±0.9)分降低至(2.7±0.6)分,但组间比较差异无统计学意义(P>0.05).两组患者术前椎体后凸角度(kyphosis angle,KA)、椎体缘高度(anterior body heights,ABH)和椎体中间高度(middle body heights,MBH)比较,差异无统计学意义(P>0.05),术后倒U型分布组均优于不规则分布组(P<0.05).术后并发症方面,倒U型分布组出现8例骨水泥渗漏,不规则分布组出现5例骨水泥渗漏,总体渗漏率为28.9%,所有骨水泥渗漏均无临床症状.继发相邻椎体骨折倒U型分布组4例,不规则分布组6例;非相邻节段骨折倒U型分布组2例,不规则分布组3例.两组间邻近节段骨折发生率比较,差异无统计学意义(P>0.05).术后1年随访倒U型分布组1例出现骨折椎体再次塌陷,再骨折率为3.1%;不规则分布组5例出现骨折椎体再次塌陷,再骨折率为14.3%.结论PVP可有效缓解胸腰段OVCF患者的疼痛,骨水泥在椎体内弥散分布情况对术后近期治疗效果无明显影响,但可能是PVP术后患椎再骨折的重要影响因素.     

经皮椎体成形术治疗骨质疏松性椎体压缩性骨折的临床效果分析

目的分析经皮椎体成形术(PVP)治疗骨质疏松性椎体压缩性骨折(OVCF)的临床疗效。方法选取该院2017-01~2018-01因OVCF行PVP治疗的患者158例(205椎),对比患者手术前后视觉模拟评分法(VAS)、Oswesty功能障碍指数(ODI)评分,伤椎前缘高度、Cobb角变化,以评价治疗效果;同时分析临床疗效与骨水泥注入量的关系。结果所有患者术后VAS评分、ODI评分均较术前明显降低,差异有统计学意义(P<0.05);术后伤椎前缘高度、Cobb角均较术前明显恢复,差异有统计学意义(P<0.05)。结论PVP治疗OVCF具有较好的临床效果,可尽早缓解疼痛,提高患者生活质量。     

Zessys椎间孔成型术与传统椎间孔成型术治疗远处脱垂型腰椎间盘突出症的临床疗效比较

目的比较Zessys椎间孔成型术与传统椎间孔成型术治疗远处脱垂型腰椎间盘突出症的临床疗效。方法选择2017-08~2019-02漯河医学高等专科学校第二附属医院收治的34例远处脱垂型腰椎间盘突出症患者的临床资料,其中17例采用Zessys椎间孔成型术治疗(A组),另17例采用传统椎间孔成型术治疗(B组)。比较两组手术时间、透视次数、术中出血量,并比较两组术前、术后第3天、术后第6个月患者的疼痛视觉模拟量表(VAS)评分、Oswestry功能障碍指数(ODI)评分、日本骨科协会评估治疗分数(JOA)评分。结果A组手术时间短于B组,术中透视次数少于B组,差异有统计学意义(P<0.05)。两组术中出血量比较差异无统计学意义(P>0.05)。两组术后第3天、第6个月的VAS、ODI评分显著低于术前(P<0.05),JOA评分显著高于术前(P<0.05);但两组在术前及术后不同时间点的VAS、ODI、JOA评分比较差异均无统计学意义(P>0.05)。结论与传统椎间孔成型术比较,Zessys椎间孔成型术在治疗远处脱垂型腰椎间盘突出症中可缩短手术时间,减少术中医患X线暴露,值得推广。     

小剂量骨水泥椎体成型术治疗老年性胸腰椎骨折的临床效果

目的探究小剂量骨水泥椎体成型术(PVP)治疗老年性胸腰椎骨折的临床效果。方法分析2016年9月-2018年2月安徽医科大学附属安庆医院骨科收治的71例老年性胸腰椎骨折患者的临床资料,根据不同的治疗方法分为对照组(n=31)和观察组(n=40)。观察组采用小剂量骨水泥PVP术治疗,对照组接受大剂量PVP术治疗。评估并比较2组的手术指标、椎体功能及疼痛改善情况、骨水泥渗漏和并发症情况。结果观察组的手术时间、骨水泥注入量及术中出血量均明显低于对照组(P<0.05),治疗后随访结果显示,观察组的伤椎椎体高度恢复值较对照组小,且视觉模拟疼痛评分(VAS)较对照组明显较低(P<0.05),但两组的Oswestry功能障碍指数(ODI)评分差异无统计学意义(P>0.05)。观察组的骨水泥渗漏、相邻椎体骨折、骨髓压迫发生率均低于对照组(P<0.05)。结论老年性胸腰椎骨折采用小剂量骨水泥PVP术后效果较好,可缩短手术时间,更有效缓解疼痛症状,减少骨水泥渗漏,降低并发症,具有一定临床应用价值。     

悬吊核心肌群训练治疗腰椎间盘突出症的临床疗效观察

目的 观察悬吊核心肌群训练治疗腰椎间盘突出症的临床疗效及其对竖脊肌、多裂肌积分肌电值(iEMG)的影响.方法 选择2018-01～2020-11吉林省一汽总医院康复医学科收治的64例腰椎间盘突出症患者,采用随机数字表法将其分为观察组和对照组,每组32例.对照组采用常规康复治疗,观察组在对照组治疗方案基础上增加悬吊核心肌...     

Effect of a short-term treatment with alendronate on bone density and bone markers in patients with central diabetes insipidus.

The aim of this open prospective randomized study was to evaluate the effect of a 6-month treatment with alendronate on the bone mineral density (BMD) at lumbar spine in patients with central diabetes insipidus. Eighteen patients with central diabetes insipidus and 18 sex- and age-matched healthy subjects entered this study. At study entry, all subjects underwent BMD assessment at the lumbar spine and measurement of serum osteocalcin (OC) and cross-linked N-telopeptides of type I collagen (Ntx). Thereafter, 9 of the 18 patients were randomized to receive treatment with alendronate at a dose of 10 mg, orally, once daily for 6 months (group 1), whereas the remaining 9 patients did not receive any treatment affecting bone status during this period (group 2). After 6 months, bone metabolism and bone density study were repeated in all patients. At baseline, lumbar BMD values (0.86+/-0.03 vs. 1.01+/-0.02 g/cm2; P<0.001) and serum OC levels (4.7+/-0.3 vs. 7.9+/-0.2 microg/L; P<0.001) were significantly lower, whereas urinary Ntx levels were significantly higher [72.0+/-1.9 vs. 64.6+/-1.7 nmol bone collagen equivalents (BCE)/nmol creatinine (Cr); P<0.01] in patients than in controls. After randomization, no difference in lumbar BMD, serum OC, or urinary Ntx was found between patients of group 1 and group 2. At the 6 month follow-up, no difference in serum OC levels was found compared to baseline evaluation in patients of both group 1 and group 2. By contrast, a significant decrease in urinary Ntx levels was found in patients of group 1 (70.3+/-3.0 vs. 75.4+/-2.1 nmol BCE/nmol Cr; P<0.05), but not in patients of group 2 (68.8+/-3.3 vs. 68.5+/-3.0 nmol BCE/nmol Cr; P = NS). A significant increase in lumbar BMD values was found in patients of group 1 (0.88+/-0.04 vs. 0.83+/-0.04 g/cm2; P<0.05), whereas a significant decrease in lumbar BMD values was found in patients of group 2 (0.86+/-0.05 vs. 0.89+/-0.05 g/cm2; P<0.05). Lumbar BMD increased 7.0+/-1.5% in patients of group 1 and decreased 4.2+/-1.8% in patients of group 2 (P<0.001). In conclusion, this study demonstrated that a 6-month treatment with alendronate in patients with central diabetes insipidus was effective in significantly improving BMD at the lumbar spine, which was significantly worsened in untreated patients. Therefore, alendronate treatment could be used in patients with central diabetes insipidus with documented osteopenia or osteoporosis.     

Effects of Long-Term Tenofovir and Entecavir Treatment on Bone Mineral Density in Patients with Chronic Hepatitis B

BackgroundWe aimed to investigate the long-term effects of tenofovir disoproxil fumarate and entecavir treatment on bone mineral density and evaluated the fracture risk assessment tool score in patients with chronic hepatitis B.MethodsA total of 58 chronic hepatitis B patients treated with tenofovir disoproxil fumarate (n = 40) and entecavir (n = 18) were included in this prospective study from 2012 to 2016. To evaluate bone mineral density, dual-X-ray absorptiometry, fracture risk assessment tool, and laboratory examinations were performed in all patients first at baseline and second at the end of the study.ResultsAge, sex, body mass index, fibrosis score, and viral load were similar in both groups. The mean follow-up was 33 months in the tenofovir disoproxil fumarate group and 31 months in the entecavir group. In patients treated with entecavir, there was no statistically significant difference between baseline and second bone mineral density including lumbar spine (L) and total hip T score. In patients treated with tenofovir disoproxil fumarate, there was a significant difference in the second bone mineral density compared with baseline bone mineral density for L3 (P = .033) and the major fracture risk assessment tool score (P = .03). When patients were divided into 3 groups (normal bone mineral density, osteopenic, and osteoporotic), there was a significant increase in the number of osteopenic patients in the total hip T score after tenofovir disoproxil fumarate treatment (P = .034).ConclusionOur results suggest a decrease in the bone mineral density for lumbar spine (L3), an increase in the number of patients with hip osteopenia, and major fracture risk assessment tool score after long-term tenofovir disoproxil fumarate treatment in patients with rechronic hepatitis B.     

Long-term excess of endogenous calcitonin in patients with medullary thyroid carcinoma does not affect bone mineral density.

In a cross-sectional study of 39 patients with medullary thyroid carcinoma (MTC), we have investigated the effects of long-term calcitonin excess on bone mineral density. Bone mineral density was measured by dual X-ray absorptiometry at the lumbar spine between the second and fourth vertebra and by single photon absorptiometry at the distal forearm. The mean observation time of each patient between diagnosis of tumour and measurement of bone mineral density was 62.4 months (range 1-158 months). The mean calcitonin serum level was 14.4 micrograms/l at the time of measurement of bone mineral density. All patients were substituted with 150-200 micrograms L-thyroxine daily. At both sites, the mean bone mineral densities of all patients with MTC were not significantly different from controls. Patients with normal calcitonin levels (below 0.2 micrograms/l) after treatment had a normal bone mineral density of the spine but significantly (P less than 0.05) reduced bone mineral density values of the forearm. This was due to the decreased body surface areas of patients in this subgroup. Patients with multiple endocrine neoplasia type IIa had significantly higher bone mineral densities. Other bone-influencing factors, such as postoperative hypoparathyroidism, calcium intake, diarrhoea, menopause, tumour stage, previous anti-tumour treatment, or thyroxine substitution dose, did not affect bone mineral density. We thus conclude that long-term excess of endogenous calcitonin in patients with MTC has no positive effect on bone mineral density.     

Changes in bone mass during low dose corticosteroid treatment in patients with polymyalgia rheumatica: a double blind, prospective comparison between prednisolone and deflazacort.

OBJECTIVE: To compare the long term effects of low dosage prednisolone or deflazacort treatments on bone mass in patients with polymyalgia rheumatica. METHODS: Thirty patients with polymyalgia rheumatica were allocated on a random double blind basis to receive treatment with prednisolone or deflazacort. Bone mineral content (BMC) was measured in the lumbar spine and in the distal forearm before treatment and three, six, and 12 months after treatment. RESULTS: At three months the decrease in lumbar BMC and bone mineral density (BMD) was significantly greater in the deflazacort group than in the prednisolone group (p < 0.05), but at six and 12 months there was no difference between the two groups. In all patients after one year there was a significant loss of BMC: a 6.4% loss in lumbar BMC and a 1.8% loss in distal forearm BMC. Loss in lumbar BMC after six months was correlated to the cumulative dose of corticosteroid (r = 0.4; p < 0.05) and was significantly greater in the group of patients who had persisting symptoms of polymyalgia at six weeks, three months, or both, after treatment started (p = 0.05). CONCLUSION: This low dose study failed to reveal any calcium sparing properties of deflazacort compared with prednisolone. Possible explanations for this finding are discussed.