Osteoporotic chronic pain:how to understand and prevent it? / 中国组织工程研究

ABSTRACT

BACKGROUND:For the treatment of osteoporosis, clinicians general y focus on improving bone mineral density and reducing the incidence of fractures, but often ignore the ease of osteoporotic chronic pain. OBJECTIVE:To review the research progress in osteoporotic chronic pain from domestic and overseas literature in recent years in order to provide reference for basic and clinical research. METHODDatabases of PubMed and Wanfang database were retrieved with key words of“osteoporosis;chronic pain;treatment of osteoporotic;vertebral compression fracture”in English and Chinese to search papers published from March 1999 to March 2014. Articles related to characteristics, pathogenesis and drug treatment of osteoporotic chronic pain as wel as surgical treatment of osteoporotic vertebral compression fractures. Final y 49 articles were summarized according to inclusion criteria. RESULTS AND CONCLUSION:The pathogenesis of osteoporotic chronic pain includes congestion mechanism and mechanisms of cytokines and lactic acid accumulation, but its exact cytological and biochemical mechanisms are not very clear. Commonly used drugs in the treatment of osteoporotic chronic pain include calcitonin and bisphosphonates. Calcitonin plays an analgesic effect by inhibiting bone resorption to indirectly reduce the hydrogen ion concentration, suppress prostaglandin synthesis, improve animal pain threshold, and increase the plasma concentration of beta-endorphin. The main pharmacological action of bisphosphonate is to inhibit osteoclast formation and activity, inhibit bone absorption, improve osteoporotic bone pain, improve bone mineral density, increase bone strength, and prevent osteoporotic fracture. Benign and malignancy tumor of the spine and osteoporotic spinal compression fractures can be treated with percutaneous vertebroplasty or percutaneous kyphoplasty. After treatment, the vertebral height can be restored completely or partial y, the kyphosis is corrected, the vertebral stability is increased and pain is relieved. Combination of various treatments is effective for the treatment of osteoporotic chronic pain, and meanwhile, the prevention and treatment of osteoporotic fractures has a positive role in prevention and treatment of osteoporotic chronic pain.