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Objective To investigate the influence of low viscosity and high viscosity bone cement in PVP on active function,anatomical index and leakage rate of patients with severe osteoporotic vertebral compression fractures (OVCF).Methods From October 2015 to June 2017,136 patients with severe OVCF were chosen in the Central Hospital of Yuncheng and randomly divided into two groups according to the digital table,with 68 patients in each group.The control group was given low viscosity bone cement by PVP scheme,and the observation group was given high viscosity bone cement by PVP.The VAS score,ODI score,SF-36 score and kyphosis Cobb angle before and after operation,the recovery rate of injured vertebrae,bone cement injection volume and postoperative cement leakage rate of the two groups were compared.Results There were no statistically significant differences in the VAS score,ODI score and SF-36 score before operation between the two groups(all P ＞0.05).The VAS score,ODI score and SF-36 score after operation of the control group were (1.90 ± 0.32) points,(30.38 ± 3.52) points,(76.07 ±9.38) points,respectively,which of the observation group were (1.94 ± 0.34) points,(29.72 ± 3.34) points,(77.10 ±9.60) points,respectively,which were significantly better than those before operation (control group:t =4.27,5.01,4.02;observation group:t =4.21,4.89,3.87,all P ＜ 0.05).There were no statistically significant differences in the VAS score,ODI score and SF-36 score after operation between the two groups (all P ＞ 0.05).The kyphosis Cobb angle after operation of the observation group was (14.02 ± 2.59) °,which was significantly lower than (16.83 ±3.31) ° of the control group and (27.78 ± 4.09) ° before operation (t =4.99,2.64,all P ＜ 0.05).The recovery rate of injured vertebrae of the observation group was (28.34 ± 5.70) ％,which was statistically significantly higher than (22.72 ± 4.16) ％ of the control group (t =3.42,P ＜ 0.05).There was no statistically significant difference in the bone cement injection volume between the two groups(P ＞ 0.05).The incidence rate of bone cement leakage in the observation group was 10.29％ (7/68),which was significantly lower than that in the control group [30.88％ (21/68)] (x2 =12.15,P ＜ 0.05).Conclusion Low viscosity and high viscosity bone cement in PVP in the treatment of patients with severe OVCF possess the same clinical effects on relieve pain and improve activity and quality of life;but high viscosity bone cement application can efficiently improve the anatomical index of injured vertebrae and avoid postoperative cement leakage.
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Objective@#To investigate the influence of low viscosity and high viscosity bone cement in PVP on active function, anatomical index and leakage rate of patients with severe osteoporotic vertebral compression fractures (OVCF).@*Methods@#From October 2015 to June 2017, 136 patients with severe OVCF were chosen in the Central Hospital of Yuncheng and randomly divided into two groups according to the digital table, with 68 patients in each group.The control group was given low viscosity bone cement by PVP scheme, and the observation group was given high viscosity bone cement by PVP.The VAS score, ODI score, SF-36 score and kyphosis Cobb angle before and after operation, the recovery rate of injured vertebrae, bone cement injection volume and postoperative cement leakage rate of the two groups were compared.@*Results@#There were no statistically significant differences in the VAS score, ODI score and SF-36 score before operation between the two groups(all P>0.05). The VAS score, ODI score and SF-36 score after operation of the control group were (1.90±0.32)points, (30.38±3.52)points, (76.07±9.38)points, respectively, which of the observation group were (1.94±0.34)points, (29.72±3.34)points, (77.10±9.60)points, respectively, which were significantly better than those before operation(control group: t=4.27, 5.01, 4.02; observation group: t=4.21, 4.89, 3.87, all P<0.05). There were no statistically significant differences in the VAS score, ODI score and SF-36 score after operation between the two groups(all P>0.05). The kyphosis Cobb angle after operation of the observation group was (14.02±2.59)°, which was significantly lower than (16.83±3.31)° of the control group and (27.78±4.09)° before operation (t=4.99, 2.64, all P<0.05). The recovery rate of injured vertebrae of the observation group was (28.34±5.70)%, which was statistically significantly higher than (22.72±4.16)% of the control group (t=3.42, P<0.05). There was no statistically significant difference in the bone cement injection volume between the two groups(P>0.05). The incidence rate of bone cement leakage in the observation group was 10.29%(7/68), which was significantly lower than that in the control group [30.88%(21/68)](χ2=12.15, P<0.05).@*Conclusion@#Low viscosity and high viscosity bone cement in PVP in the treatment of patients with severe OVCF possess the same clinical effects on relieve pain and improve activity and quality of life; but high viscosity bone cement application can efficiently improve the anatomical index of injured vertebrae and avoid postoperative cement leakage.
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Durante anos a obesidade foi vista como um fator protetor para fraturas e osteoporose. Diversos estudos, no entanto, contestam esta tese, descrevendo que a obesidade na verdade afeta negativamente o sistema esquelético, em especial a homeostase óssea, diminuindo a rigidez do tecido ósseo e aumentando o risco de fraturas. A obesidade e o diabetes estão frequentemente associados no mesmo paciente, e a compreensão da alteração do tecido ósseo nestas duas condições clínicas é fundamental para o melhor cuidado destes pacientes, principalmente devido ao risco aumentado de fraturas, que estão associadas a maior número de complicações no seu tratamento. O presente estudo, em revisão narrativa, descreve a relação entre obesidade e homeostase óssea, a fragilidade óssea nos pacientes obesos, diabéticos ou não, e a relação entre obesidade e fraturas.
Obesity has seen as a protective factor for fractures and osteoporosis for ages. However, several studies challenged this thesis and reported obesity really affects skeletal system negatively, especially bone homeostasis, decreasing bone tissue stiffness and rising the risk of fractures. Data demonstrate that obesity and diabetes are frequently associated in the same patient, and that understanding the alteration of bone tissue in these two clinical conditions is fundamental for the better care of these patients, mainly due to the increased risk of fractures, which are associated with greater number of complications in their treatment. This narrative review aims to describe the relationship between obesity and bone homeostasis, bone fragility in obese patients with or without diabetes, and the relationship between obesity and fractures.
Subject(s)
Diabetes Mellitus , Obesity , Osteoporosis , Bone and Bones , Risk Factors , Diabetes Mellitus, Type 2 , Fractures, BoneABSTRACT
Clinical data of 448 patients aged ≥60 years with osteoporotic hip fractures admitted in Shanghai Huashan Hospital between January 2010 and December 2014 were retrospectively analyzed.Among 448 cases,there were 143 males and 305 females;196 cases aged 80-89 years (43.8％) and 137 cases aged 70-79 years (30.6％);304 cases of femoral neck fracture (67.9％) and 144 cases of intertrochanteric femoral fracture (32.1％);the fractures caused by fall in 328 cases (73.2％) and comorbidity with hypertension and diabetes mellitus in 415 cases (92.6％).Two hundred and sixty eight patients were followed up for 2 years,among whom re-fractures occurred in 17 cases.The study indicates that health education is important for prevention of osteoporotic fractures in elderly people.
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Objective To analyze the early clinical efficacy of alendronate sodium on residual pain after vertebral angioplasty for osteoporotic vertebral compression fractures.Methods By drug single treatment method,a total of 30 elderly patients with residual pain after vertebral angioplasty for osteoporotic vertebral compression fractures were included.Patients were randomly divided into 2 groups:the treatment group and the control group.All patients were given calcium carbonate D3 treatment,and the treatment group was given alendronate sodium treatment additionally.6 weeks after the treatment,visual analogy score (VAS) was used for the evaluation of pain relief.Results All patients were followed up for 6 weeks.At the end of follow-up,the rates of pain relief were 86.8％ in treatment group and 13.2％ in control group.There was a significant difference in visual analogy scores between the treatment group and the control group[(0.51±0.32),(1.59±1.21) ; t=3.4,P＜0.001],which showed the degree of pain relief was higher in the treatment group than in control group.Conclusions Alendronate sodium is effective and reliable for the treatment of residual pain after vertebral angioplasty for osteoporotic vertebral compression fractures.This study provides the scientific reference for the treatment and research of residual pain after vertebral angioplasty for osteoporotic vertebral compression fractures.