CAJ | 학술논문

目的：观察特立帕肽在预防绝经后骨质疏松患者腰椎融合术后椎弓根螺钉松动治疗中的作用。方法72名绝经后骨质疏松患者，诊断为腰椎退行性滑脱，随机分为3组：特立帕肽组（n＝24，每日行皮下注射20μg teriparatide），双磷酸盐组（n＝24，每日口服2.5mg 利塞膦酸risedronate），空白对照组（n＝24）。所有患者均接受腰椎管减压及1个节段后外侧融合手术，术后12月运用摄片、CT、临床体检等方法判断椎弓根螺钉松动及临床疗效。结果术后12月随访时，特立帕肽组螺钉松动率：X线摄片为7％，CT为12％；利塞膦酸组分别为13％和25％；空白对照组为14％和25％。特立帕肽组椎弓根螺钉松动率明显低于利塞膦酸组及空白对照组（P＜0.05），而利塞膦酸组椎弓根螺钉松动率与空白对照组无明显差别（P＞0.05）。末次随访时三组间临床评分无显著差异（ P＞0.05）。结论特立帕肽能够增强腰椎椎体松质骨及椎弓根皮质骨强度，降低螺钉松动发生率。
목적：관찰특립파태재예방절경후골질소송환자요추융합술후추궁근라정송동치료중적작용。방법72명절경후골질소송환자，진단위요추퇴행성활탈，수궤분위3조：특립파태조（n＝24，매일행피하주사20μg teriparatide），쌍린산염조（n＝24，매일구복2.5mg 리새련산risedronate），공백대조조（n＝24）。소유환자균접수요추관감압급1개절단후외측융합수술，술후12월운용섭편、CT、림상체검등방법판단추궁근라정송동급림상료효。결과술후12월수방시，특립파태조라정송동솔：X선섭편위7％，CT위12％；리새련산조분별위13％화25％；공백대조조위14％화25％。특립파태조추궁근라정송동솔명현저우리새련산조급공백대조조（P＜0.05），이리새련산조추궁근라정송동솔여공백대조조무명현차별（P＞0.05）。말차수방시삼조간림상평분무현저차이（ P＞0.05）。결론특립파태능구증강요추추체송질골급추궁근피질골강도，강저라정송동발생솔。
Objective To observe the effect of teriparatide on preventing pedicle screw loosening in postmenopausal patients with osteoporosis after lumbar fusion.Methods Seventy-two patients with postmenopausal osteoporosis, who were diagnosed with degenerative spondylolisthesis, were randomly divided into three groups ( n=24):the teriparatide group, the bisphosphonate group, and the blank control group.Patients in the teriparatide group were given a subcutaneous injection of 20 μg teriparatide per day. Patients in the bisphosphonate group took an oral medication of 2.5 mg risedronate per day.All the patients underwent lumbar canal decompression and a segment posterolateral fusion surgery.At the 12th month after the surgery, the radiography, CT, clinical examination, and other methods were used to determine the degree of pedicle screw loosening and the clinical efficacy.Results At the 12th month postoperative follow-up, the screw loosening rate in teriparatide group according to X-ray and CT was 7% and 12%, respectively.It was 13% and 25% in risedronate acid group, respectively.It was 14% and 25% in blank control group, respectively.The rate of pedicle screw loosening in the teriparatide group was significantly lower than that in the risedronate group and the blank control group (P<0.05).No significant difference was observed between the risedronate group and the blank control group ( P>0.05 ) .At the last follow-up, clinical scores among the three groups showed no significant difference ( P>0.05 ) . Conclusion Teriparatide can enhance the strength of the pedicle cortical bone and reduce the incidence of pedicle screw loosening.