ABSTRACT
BACKGROUND: In recent years, percutaneous kyphoplasty (PKP) has been widely used in the treatment of osteoporotic vertebral compression fractures, but there are still some complications, such as bone cement leakage and re-fractures, and a lack of follow-up treatment.OBJECTIVE: To investigate the effect of PKP with low-dose bone cement in combination with zoledronic acid on bone mineral density (BMD), vertebral height and low back pain after osteoporotic vertebral compression fractures.METHODS: Eighty patients with osteoporotic vertebral compression fractures were equally randomized into test group (treated with PKP with low-dose bone cement in combination with zoledronic acid) and control group (treated with PKP with conventional bone cement). Visual analog scale score, vertebral height, and Cobb angle were detected before, at 3 days after treatment and at the final follow-up visit. BMD and re-fracture incidence were reviewed 1 year after treatment.RESULTS AND CONCLUSION: Visual analog scale scores, vertebral height, and Cobb angle were significantly improved in both groups at 3 days after treatment and at the final follow-up visit (P < 0.05); however, there was no statistical difference between the test and control groups. One year after treatment, the BMD value was significantly increased in the test group (P < 0.05), but showed no change in the control group as compared with the pretreatment.Postoperatively adjacent vertebral fractures were found in one case of the test group, and five cases in five cases of the control group. These findings indicate that PKP with low-dose bone cement in combination of zoledronic acid can effectively relieve pain symptoms, restore the height of the vertebral body, significantly increase BMD value and reduce the incidence of adjacent vertebral fractures in patients with osteoporotic vertebral compression fractures.
ABSTRACT
Objective To investigate the biological characteristics of primary osteoporosis syndrome types from the perspective of mitochondrial DNA ( mtDNA) , thus to reveal the nature of osteoporosis and its traditional Chinese medical syndrome types. Methods A total of 210 osteoporosis women patients meeting the diagnostic criteria, inclusion criteria and exclusion criteria were collected from July of 2011 to October of 2013. The osteoporosis patients were differentiated into the syndrome types of yin deficiency of liver and kidney ( N=67) , yang deficiency of spleen and kidney ( N=70) and qi stagnation and blood stasis ( N=73) . And a total of 69 age-matched post-menopause non-osteoporosis patients were chosen as the control group, which were classified into the syndrome of harmony of Qi and blood. The peripheral blood was sampled for detecting mtDNA copy number with fluorescent quantitatitation PCR and for examining 8-hydroxy-2’-deoxyguanosine ( 8-OHdG) content by enzyme-linked immunosorbent assay (ELISA) . Statistical methods was used to analyze the correlation of bone mineral density (BMD) with mtDNA copy number and 8-OHdG content in different groups. Results The difference of mtDNA copy number was significant between the osteoporosis patients and non-osteoporosis patients (P<0.05), and was also significant among the three syndrome types of osteoporosis patients (P<0.05) . And 8-OHdG content showed the same features between the osteoporosis patients and non-osteoporosis patients (P<0.05) and among the three syndrome types of osteoporosis patients (P<0.05) . The correlation analysis results showed that mtDNA copy number was positively correlated with BMD, while 8-OHdG was negatively correlated with BMD in each group. Conclusion The mtDNA copy number and 8-OHdG content are correlated with the syndrome types of primary osteoporosis patients, and close correlation is shown between spleen-kidney yang deficiency and 8-OHdG, and between liver-kidney yin deficiency and mtDNA copy number.