骨代谢标志物与骨密度预测经皮穿刺椎体成形术后椎体再骨折的价值

目的 探讨椎体骨密度及骨代谢标志物在老年骨质疏松性胸腰椎骨折经皮穿刺椎体成形术(percutaneous vertebro plasty,PVP)后预测椎体再骨折发生的价值.方法 采用回顾性分析方法收集2018年1月-2019年1月在同济大学附属第十人民医院接受椎体成形术治疗的老年骨质疏松性胸腰椎压缩性骨折患者50例,...

Bone mineral density and bone metabolism markers for predicting vertebral refracture in elderly patients after percutaneous vertebroplasty

ObjectiveTo assess the value of vertebral bone mineral density(BMD) and bone metabolism markers for predicting vertebral refracture after percutaneous vertebroplasty(PVP) in elderly patients with osteoporotic thoracolumbar fractures. MethodsFifty elderly patients with osteoporotic thoracolumbar compression fractures treated by bone cement molding in our hospital from January 2018 to January 2019, were included in the study. The adjacent vertebral refractures occurred in 23 cases(refracture group) and did not occur in 27 cases(non-refracture group). Dual energy X-ray absorptiometry(DXA) was used to measure the bone mineral density(BMD) of single non-operated vertebral body and hip before and 6,12 months after operation. Serum osteocalcin N-terminal middle molecular fragment(N-MID) and 25 hydroxyvitamin D[25(OH)D] levels were detected by enzyme-linked immunosorbent assay(ELISA). ResultsCompared to that before operation, the BMD of adjacent vertebral bodies in the non-fracture group decreased at 6 months and 12 months after operation with the reduction rates of 7.80% and 18.50%(P=0.000), respectively. The BMD of hip in the refracture group was lower than that in the non fracture group at 6 and 12 months after operation(P<0.001,P=0.000). The levels of serum N-MID and 25(OH)D in the refracture group were lower than those in the non-fracture group(P=0.000). Logistic regression analysis showed that the occurrence of refracture was negatively correlated with the serum levels of osteocalcin N-MID and 25(OH)D(P=0.033,P=0.031). ConclusionThe decreased BMD of adjacent vertebral body and hip, serum levels of osteocalcin N-MID and 25(OH)D in elderly patients with osteoporosis are prone to refracture of adjacent vertebral bodies after PVP.