Parathyroid hormone 1-34 in the treatment of adjacent vertebral refracture after percutaneous kypho-plasty for thoracolumbar osteoporotic compression fracture / 中华创伤骨科杂志

ABSTRACT

Objective:To evaluate the efficacy of parathyroid hormone 1-34 (PTH1-34) in the treat-ment of adjacent vertebral refracture after percutaneous kyphoplasty (PKP) for thoracolumbar osteoporotic com-pression fracture (OVCF).Methods:A retrospective study was made of the 43 OVCF patients who had been admitted to Department of Orthopedics, Shanxi Bethune Hospital for adjacent vertebral refracture after PKP from January 2014 to June 2018.Of them, 22 were treated by secondary PKP (group A), 9 by secondary PKP+PTH1-34 (group B), and 12 by merely PTH1-34 (group C).The vertebral heights of anterior border and middle-line and sagittal kyphosis cobb angle on X-ray films at 6 months after operation, the bone mineral den-sities of the left hip at admission, 6 and 12 months after operation, and the Oswestry Dysfunction Index (ODI) and Visual Analog Scale (VAS) scores at admission, 3, 6 and 12 months after operation were recorded and compared.Results:The 3 groups were compatible because there were no significant differences between them in the preoperative general data ( P>0.05).Recurrent OVCF was found in 3 patients in group A but not in group B or C.The vertebral heights and kyphosis cobb angle at 6 months after operation were significantly improved compared to the preoperative values in groups A and B ( P<0.05) but not in group C.The T values of bone mineral density at 6 and 12 months after operation in group B and at 12 months after operation in group C were significantly improved compared to their preoperative ones ( P<0.05) but not in group A.The post-operative ODI and VAS scores were significantly improved compared to the scores at admission in all the 3 groups ( P<0.05). Conclusions:In the treatment of adjacent vertebral refracture after PKP for elderly OVCF patients, PTH1-34 can significantly improve their bone mineral density, prevent collapse of the injured vertebra and reduce re-fracture of adjacent vertebral body.A combination of PTH1-34 and PKP is an effective treatment of adjacent vertebral refracture after PKP because it can restore the vertebral heights and reduce kyphosis deformity.