Clinical Study Of Integrated Therapy In Treating Thoracolumbar Osteoporotic Vertebral Compression Fractures

BackgroundOne of common complication of osteoporosis is thoracolumbar osteoporotic vertebral compression fractures.The human is gradually stepping into aging society, osteoporotic vertebral compression fractures increase significantly.The treatment of thoracolumbar osteoporotic vertebral compression fractures used non-surgical treatment in the past,such as staying in bed,with a fixed,taking analgesic drugs and exercising back muscle,pain relief is obvious in the process of treatment.However,the treatments lead to osteoporosis further than "before,it is a vicious sycle.Osteoporotic vertebral compression fractures patients are usually older persons.It is easiercausing tract complications such as infection,hypostatic pneumonia and bedsore. The traditional open surgery trauma to the human body is large, osteoporosis of the patients make internal fixation with pedicle screws loose easily limiting the clinical application.With the emergence of the percutaneous vertebral plasty and the percutaneous kyphoplasty,they relieve the pain and improve the treatment of the patient’s life. However, minimally invasive technology did not solve the nature of the osteoporosis, there is still a vertebral fracture recurrence and the risk of postoperative residual pain. ObjectiveTo observe the clinical effect of different drugs with or without minimally invasive surgical in treating thoracolumbar osteoporotic vertebral compression fractures.MethodsWe adopted the ran actures were randomly divided into4equal groups,group A in which the treatment was activated vitD3combined with calcium,group B was activated vitD3combined with calcium and zoledronic acid,group C was activated vitD3combined with calcium and percutaneous vertebroplasty(PVP),and group D was activated vitD3and calcium combined with Zoledronic acid and PVP.we followed-up of1week,3months and6months,and evaluated the effect according to the VAS pain score standard and bone mineral density(BMD).ResultsGroup B compared with group A, VAS score had statistical significant different(P<0.05)after treatment of1month,3months,6months;1week after the therapy, group D(3.37±0.38)compared with group A (7.43±1.43)and group B (7.23±0.93) respectively,the VAS score had statistical significant difference (P<0.05),there was not statistical significant difference compared with group C (P=0.862,P>0.05);1,3and6months after the therapy, group D was2.07±0.24,1.84±0.22and1.24±0.14respectively,there was statistical significant difference (P<0.05) compared with others group respectively. the bone mineral density of group A an group C after therapy had not statistical significant difference compared with the prior treatment (P>0.05), while group B (0.659±0.052) g/cm2and group D (0.666±0.049) g/cm2was adverse(P<0.05).and it had not statistical significant difference compared with group B and group D (P>0.05),but it had statistical significant difference compared with group A and group C respectively (P<0.05). Conclusion1. Activated vitD3and calcium combined with zoledronic acid can effectively improve the bone mineral density,they can alleviate pain of the osteoporotic vertebral compression fractures1month later.2. Application of the activated vitD3and calcium combined with zoledronic acid and PVP could obviously alleviate pain of the osteoporotic vertebral compression fractures,could improve the bone mineral density,and could prevent further development of osteoporosis.