摘要
目的探讨后路椎体间融合术(posterior lumbar interbody fusion,PLIF)联合唑来膦酸与维生素D治疗并发老年骨质疏松的腰椎退行性疾病的中长期临床疗效。方法将2017年1月-2020年12月盐城市大丰人民医院骨科收治的120例行PLIF手术治疗的骨质疏松性腰椎退变疾病患者按数字随机法分为研究组和对照组,每组各60例。研究组在术前开始给予口服维D钙咀嚼片、术后静滴唑来膦酸抗骨质疏松,对照组仅给予口服维D钙咀嚼片,对两组患者临床疗效进行总结分析。结果两组共120例患者均获至少两年的随访,随访时间24.8~28.7个月,平均25.6个月;两组患者术后1个月、6个月、12个月、末次随访的疼痛视觉模拟量表(VAS)评分、Oswestry功能障碍指数(ODI),均较术前明显改善,差异有统计学意义(P<0.05),但术后6个月开始研究组的VAS评分及ODI指数明显优于对照组(P<0.05);术后12月至末次随访两组骨密度对比有显著差异(P<0.05),且对照组的椎间隙高度相对于术后即刻的丢失大于研究组。结论PLIF术后联合唑来膦酸与维生素D治疗骨质疏松腰椎退变性疾病,能显著缓解慢性腰痛、改善生活质量等优点,具有良好的临床疗效。
Objective To investigate medium and long-term clinical effect of posterior lumbar interbody fusion(PLIF)combined with zoledronic acid and vitamin D in treatment of lumbar degenerative disease complicated with senile osteoporosis.Methods The paper chose120 patients with lumbar degenerative disease caused by osteoporosis treated by PLIF in Department of Orthopaedics of Yancheng City Dafeng People's Hospital from January 2017 to December 2020,and divided them into study group and control group randomly according to the number.Study group was treated with oral vitamin D calcium chewable tablets before operation,control group with oral vitamin D calcium chewable tablets after operation.Clinical effect between two groups was summarized and analyzed.Results 120 patients in both groups were followed up for at least two years,with follow-up time of 24.8~28.7 months,with average of 25.6 months;pain visual analogue scale(VAS)scores and Oswestry dysfunction index(ODI)between two groups at 1 month,6 months,12 months and the last follow-up were significantly better than before surgery,with statistically significant difference(P<0.05).However starting from 6 months after surgery,VAS scores and ODI index of study group were significantly better than control group(P<0.05).There was significant difference in bone density between two groups from 12 months after surgery to the last follow-up(P<0.05)and loss of intervertebral space height in control group was greater than study group immediately after surgery.Conclusion Combination of zoledronic acid and vitamin D after PLIF surgery can alleviate chronic low back pain and improve quality of life in treatment of osteoporotic lumbar degenerative diseases significantly,which has good clinical effect.
作者
倪晓辉
巴春
程应华
陈金晶
张志勇
NI Xiaohui;BA Chun;CHENG Yinghua;CHEN Jinjing;ZHANG Zhiyong(Department of Orthopaedics,Yancheng City Dafeng People's Hospital,Yancheng,Jiangsu 224100;Department of Orthopaedics and Traumatology,Yancheng City Dafeng Hospital of Traditional Chinese Medicine,Yancheng,Jiangsu 224100)
出处
《智慧健康》
2023年第19期125-128,共4页
Smart Healthcare
基金
盐城市科技计划项目《老年骨质疏松性腰椎退变性疾病综合治疗策略》(项目编号:YK2019090)。
关键词
骨质疏松症
腰椎退变性疾病
后路椎体间融合术
唑来膦酸
Osteoporosis
Lumbar degenerative disease
Posterior Intervertebral Fusion(PLIF).Zoledronic acid
