ABSTRACT
Background: Athletes and fitness enthusiasts often encounter thoracolumbar compression fractures due to rigorous physical activities. Combining calcium (Ca) and zoledronic acid (ZOL) with percutaneous kyphoplasty (PKP) has shown promising clinical efficacy in elderly patients with osteoporotic thoracolumbar compression fractures (OTCF). However, the potential benefits of this approach in athletes and fitness enthusiasts require further investigation. Methods: We conducted a retrospective analysis of 295 athletes and fitness enthusiasts (mean age 75.91±3.74 years) with OTCF who underwent PKP. Patients were divided into three groups: PKP+Ca (n=92), receiving 1500mg/d Ca carbonate post-surgery; PKP+ZOL (n=98), receiving 5mg ZOL intravenously post-surgery; and PKP+Ca+ZOL (n=105), administered with a combination of Ca and ZOL post-surgery. A two-year follow-up was conducted, and clinical and imaging data were recorded and analyzed before and after treatment. Results: There were no significant differences in general information, lumbar bone mineral density (BMD), visual analog scale (VAS), Oswestry dysfunction index (ODI), and bone marker levels among the three groups before treatment. In the 3rd, 6th, 12th, and 24th months post-treatment, the PKP+Ca+ZOL group exhibited higher vertebral heights compared to the PKP+Ca and PKP+ZOL groups. Additionally, in the 6th, 12th, and 24th months post-treatment, the PKP+Ca+ZOL group demonstrated lower kyphosis than the PKP+Ca and PKP+ZOL groups. Furthermore, in the 12th and 24th months post-treatment, the PKP+Ca+ZOL group had higher BMD values than the PKP+ZOL and PKP+Ca groups. VAS scores in the PKP+Ca+ZOL and PKP+ZOL groups were significantly lower than those in the PKP+Ca group. ODI scores and bone marker concentrations were also lower in the PKP+Ca+ZOL group compared to the other groups. (AU)
Subject(s)
Humans , Male , Female , Aged , Athletes , Kyphoplasty , Fractures, Compression , Retrospective Studies , Zoledronic Acid , Calcium , ExerciseABSTRACT
OBJECTIVES: The purpose of this study was to determine the association between the bone mineral density (BMD) and severity of spinal osteoarthritis (spondylosis) in osteoporotic spinal compression fracture. METHODS: Fifty six patients were evaluated 66 cases had an osteoporotic thoracolumbar compression fracture between January 2008 and June 2010. The average patient age was 76.2 years (M/F : 8/48). Age and body mass index (BMI, kg/m2) were measured, and the BMD was performed using peripheral quantitative computed tomography (pQCT). Simple thoracolumbar (T-L) spine lateral radiography was evaluated for three criteria: presence of osteophytes, disc space narrowing and vertebral body sclerosis. The findings were graded 0 to 3 and analyzed statistically for a correlation with the BMD and fractured vertebrae. RESULTS: Acute compression fractures comprised of 15 cases and the most common site of acute fractures with old fractures was lumbar spine (L1; 30 cases, 45.4%). The average of BMI was 23.32 and BMD (T-score) was -4.47. Pearson's rho showed a positive association between the weight, height and the BMD (P < 0.01). In terms of the BMD versus spondylosis, there was a positive association with high score in the high order cortical bone. Compression fractures occurrence rate in the absent and present of spondylosis was 74.3% and 22.4%, and 69% occur in the spinal segmental with no bony spur with chi-square test (P < 0.01). CONCLUSION: In the present of spondylosis was high score of cortical BMD and low rate of compression fracture. Spondylosis could be one of a factor of the occurrence in acute and adjacent compression fracture after old fractures.
