| Objective To explore the clinical effect of anti-osteoporosis combined medication on elderly female patients with lumbar disc herniation and osteoporosis.Methods A retrospective analysis was performed for 158 elderly women with osteoporosis diagnosed and treated in the osteoporosis clinic of the Affiliated Hospital of North China University of Science and Technology from December 2012 to June 2019.Among them,78 cases of osteoporosis combined with lumbar disc herniation(43 cases of central type,35 cases of paracentral type,all patients with mild to moderate lumbar disc herniation)were in OP+LD group,and the average follow-up time was(16.69±3.52)months.In OP group,80 cases of osteoporosis without lumbar disc herniation were followed up for an average of(16.98±3.74)months.In both groups,70 mg alendronate sodium tablets were orally taken once a week for 1~2 years on the basis of a daily combination of calcium carbonate-D3 D600 mg and calcitriol 0.25 ug.During follow up record the patient's age,height,weight and other basic data before treatment,measured and record the bone mineral density(BMD)of the lumbar spine and left femur and their change rates,visual analogue scores(VAS)of pain,and Japanese Orthopaedic Association Scores(JOA)before and after treatment.Then evaluated the efficacy of patients before and after treatment.Results 1 Before treatment,there was no statistically significant difference in age,height,weight,menopausal age,and VAS score between the OP+LD group and the OP group(P>0.05).2 BMD comparison: Before treatment,there was no statistically significant difference in BMD of the lumbar spine and the left femoral neck between the OP+LD group and the OP group(P>0.05);after treatment,the BMD of the lumbar spine of the OP+LD group was lower than that of the OP group with statistical significance(Z=-2.024,P<0.05);there was no statistically significant difference between the left femoral neck BMD of OP+LD group and OP group(Z=-0.685,P>0.05);before and after treatment,the lumbar spine BMD and left femoral neck BMD of the OP+LD group and the OP group were significantly improved,and the differences were both statistically significant(P<0.05).3 BMD change rates: After treatment,in the OP+LD group,the change rate of lumbar spine BMD in the OP+LD group was(4.96±0.98)%,and of the left femoral neck BMD was(3.53±1.50)%;in the OP group,the change rate of the lumbar BMD was(7.52±1.34)%,and of the left femoral neck BMD is(3.35±0.86)%.After treatment,the change rate of lumbar spine BMD in OP + LD group was lower than that in OP group,and the difference was statistically significant(Z=-9.531,P<0.05);the difference in the BMD change rate of the femoral neck between the two groups was not statistically significant(Z=-0.009,P>0.05).4 VAS score: Before and after treatment,the VAS scores of the OP+LD group and the OP group were significantly improved,the difference was statistically significant(P<0.05);after treatment,the VAS score of the OP+LD group was higher than that of the OP group,the difference was statistically significant(Z=-2.272,P<0.05).5 JOA score: Before treatment,the JOA score of the OP+LD group was lower than that of the OP group,the difference was statistically significant(Z=-4.008,P<0.05);after treatment,the JOA score of the OP+LD group was lower than that of the OP group,the difference statistically significant(Z=-3.834,P<0.05).Comparison of JOA improvement: both groups of JOA scores were significantly improved.After treatment,the difference between the two groups in the improvement of JOA was statistically significant(Z=-2.053,P<0.05).6 During treatment,7 patients in the OP+LD group developed mild gastrointestinal reactions and rash symptoms;6 patients in the OP group developed mild gastrointestinal reactions and rash symptoms.All patients could tolerate the symptoms gradually relieved after continuing treatment.No serious adverse reactions were observed.Conclusions 1 The combined anti-osteoporosis medication has a good effect on elderly female patients with osteoporosis accompanied by lumbar disc herniation,the lumbar pain can be significantly relieved,and the ability of daily life can be improved.2 Lumbar disc herniation has an effect on the treatment of osteoporosis and delays the increase of vertebral bone density.In the treatment of osteoporosis,the lumbar disc herniation should also be considered.3 The combined anti-osteoporosis medication is effective and safe for elderly women with osteoporosis.Figure 4;Table 7;Reference 177... |
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