术前应用特立帕肽对骨质疏松患者腰椎手术效果的影响  

Effect of preoperative application of teriparatide on outcome of lumbar spine surgery in osteoporotic patients

作　　者：王子逸 李经坤 王之锦 韩文哲 邹德波 WANG Ziyi;LI Jingkun;WANG Zhijin;HAN Wenzhe;ZOU Debo(School of Clinical Medicine,Shandong Second Medical University,Weifang 261000,China;不详)

机构地区：[1]山东第二医科大学临床医学院,山东潍坊261000 [2]山东第一医科大学第一附属医院脊柱外科,山东济南250000 [3]聊城市人民医院骨科,山东聊城252000 [4]山东第一医科大学临床医学院,山东济南250000

出　　处：《山东医药》2025年第4期98-103,共6页Shandong Medical Journal

基　　金：山东省自然科学基金青年项目(ZR2020QH077)。

摘　　要：目的观察术前应用特立帕肽对骨质疏松患者腰椎手术效果的影响,为临床治疗骨质疏松性腰椎疾病提供参考。方法回顾性收集术前应用特立帕肽抗骨质疏松治疗的骨质疏松症腰椎手术患者30例(特立帕肽组),术前未行特立帕肽治疗的骨质疏松症腰椎手术患者30例(对照组)。特立帕肽组术前3~6个月行特立帕肽抗骨质疏松规范治疗,两组均行腰椎后路融合术。比较两组手术相关指标(手术时间、失血量、手术节段数、术后引流量),术后6个月及末次随访时椎间植骨融合率,骨质疏松相关并发症(螺钉松动、融合器沉降、新发椎体压缩性骨折)发生情况,术前、术后3个月、末次随访时骨密度T值及术前、术后3个月和末次随访时Oswestry功能障碍指数(ODI)、腰腿痛视觉模拟评分法(VAS)评分。结果两组手术时间、术中失血量、手术节段数、术后引流量比较差异均无统计学意义(P均>0.05)。特立帕肽组螺钉松动、融合器沉降、新发椎体压缩性骨折发生率均低于对照组,术后6个月及末次随访时椎间植骨融合率均高于对照组(P均<0.05)。与对照组同时点比较,特立帕肽组末次随访时骨密度T值高于对照组(P<0.05),两组术前、术后3个月骨密度T值比较差异均无统计学意义;与同组术前比较,特立帕肽组末次随访时骨密度T值高于术前(P<0.05),对照组术后3个月、末次随访时骨密度T值与术前比较差异均无统计学意义。两组术前ODI、VAS评分比较差异均无统计学意义,特立帕肽组术后3个月、末次随访时ODI、VAS评分均低于对照组(P均<0.05)。结论术前应用特立帕肽可提高骨质疏松症患者腰椎手术的椎间植骨融合率,增加骨密度,降低术后并发症发生率,从而改善手术治疗效果。Objective To observe the clinical effect of preoperative application of teriparatide on the outcome of lum-bar spine surgery for patients with osteoporosis,and to provide reference for the clinical treatment of osteoporotic lumbar spine diseases.Methods A retrospective collection was conducted on 30 patients undergoing lumbar spine surgery for osteoporosis who received preoperative treatment with teriparatide(teriparatide group),and 30 patients undergoing lumbar spine surgery for osteoporosis who did not receive preoperative treatment with teriparatide(control group).Patients in the teriparatide group received standardized treatment with teriparatide for osteoporosis 3-6 months before surgery,and pa-tients in both groups underwent lumbar posterior fusion surgery.We compared two sets of surgical related indicators(surgi-cal time,blood loss,the number of surgical segments,and postoperative drainage volume),intervertebral fusion rate at 6 months and at the last follow-up,the occurrence of osteoporosis-related complications(screw loosening,fusion device sub-sidence,new vertebral compression fractures),bone density T values before surgery,at 3 months after surgery,and at the last follow-up,as well as Oswestry Disability Index(ODI)and Visual Analog Scale(VAS)scores for lumbar and leg pain before surgery,at 3 months after surgery,and at the last follow-up.Results There were no statistically significant differ-ences in surgical time,intraoperative blood loss,the number of surgical segments,or postoperative drainage volume be-tween the two groups(all P>0.05).The incidence of screw loosening,fusion cage settling,and new vertebral compression fractures in the teriparatide group was lower than that in the control group;the fusion rate of intervertebral bone graft at 6 months after surgery and at the last follow-up was higher than that in the control group(P<0.05).Compared with the con-trol group at the same time point,the T value of bone density in the teriparatide group was higher than that in the control group at the last

关 键 词：特立帕肽 骨质疏松症 腰椎融合术 骨密度 

分 类 号：R681.5[医药卫生—骨科学]