鲑鱼降钙素与骨水泥成形术治疗骨质疏松性椎体压缩骨折的临床比较

目的探讨鲑鱼降钙素及骨水泥成形术治疗骨质疏松性椎体压缩骨折(OsteoporoticvertebralcompressionfracturesOVCFs)的临床疗效。方法回顾性分析66例OVCFs患者,应用骨水泥成形术治疗46例,其中椎体成形术(percuta-neousvertebroplastyPVP)治疗25例,后凸成形术(percutaneouskyphoplastyPKP)治疗21例;鲑鱼降钙素等药物治疗20例。治疗后随访12～20个月,平均14个月,记录对比疼痛视觉模拟评分(VisualanaloguescalesVAS),用SF-12(ShortForm-12)健康调查评分表评价其生活质量变化,记录骨水泥成形术组椎体高度变化和Cobb角改善情况,降钙素组骨密度变化情况。结果所有患者腰背疼痛均有不同程度减轻,手术无明显并发症。VAS评分:各组治疗前后比较差异有统计学意义(P﹤0.05)。术后1周骨水泥成形术组患者VAS评分优于降钙素治疗组(P﹤0.05);术后两周各组间VAS评分差异无统计学意义(P﹥0.05);SF-12健康调查评分:各组治疗前后比较差异明显(P﹤0.05),组间差异不明显。伤椎压缩恢复程度:骨水泥治疗组伤椎Cobb角及椎体高度均有所改善,总体看PKP优于PVP(P﹤0.01)。骨密度变化:降钙素组骨密度治疗后有提高(P﹤0.05)。结论骨水泥成形术治疗OVCFs能够迅速缓解疼痛,改善椎体高度和Cobb角,增加脊柱稳定性;鲑鱼降钙素等药物治疗早期也可缓解疼痛,但止疼效果较骨水泥成形术滞后两周,药物及手术治疗均能明显提高患者生活质量。

Treatment of osteoporotic vertebral compression fractures:clinical application of bone cementoplasty and Salmon calcitonin

OBJECTIVE To study the effect of therapies including bone cementoplasty and Salmon calcitonin in treating OVCFs.METHODS There WERE 66 cases of OVCFs.Fourty-six cases were treated with bone cementoplasty therapy,of which PVP was done in 25cases and PKP was done in 21 cases.Twenty cases was done with Salmon calcitonin.A follow up for 12-20 months(average 14 months)was carried out to compare VAS and SF-12 health survey,recorded the changes of vertebral height and Cobb angle,detected the bone mineral density.RESULTS Therapies were successful in all cases,with distinct pain relief without obvious complications.VAS:there were obvious differences before and after treatment in every group(P﹤ 0.05).The bone cementplasty’s VAS outweigh Salmon calcitonin’s after a week of operation(P﹤0.05),two weeks after operation,there were no significant differences between them.SF-12 health survey:there were obvious differences before and after treatment in every group(P﹤0.05).Calcitonin’ score from SF-12 health survey was lower to bone cementoplasty and showed a fluctuate.The degree of recovery of compressing vertebra:Cobb angle and vertebra height improved in bone cementoplasty group that PKP group was better than PVP group in general(P﹤0.01).Bone mineral density:the bone mineral density of calcitonin group was improved after therapy(P﹤0.05).CONCLUSION Bone cementoplasty(PVP and PKP)can quickly relief pain,improve vertebral height and cobb angle,enhance vertebral stability.Salmon calcitonin can improve BMD and relief pain,while the effect of relief pain in earlier period will postpone about 2 weeks comparing with bone cementoplasty.All methods can elevate the quality life of patients in treating OVCFs.