Abstract:Objective To study the relationship between serum vitamin D level and non-operative recurrent vertebral fracture after percutaneous vertebral augmentation(PVA).Methods The basic data of patients with osteoporotic vertebral compression fracture(OVCF) treated by PVA in the Department of Orthopaedics of Kunming first people's Hospital from January 2017 to January 2021 were collected,including age,sex,preoperative bone mineral density,25-hydroxyvitamin D value,mode of operation,operative vertebral segment and serum 25-hydroxyvitamin D value after operation.The patients were followed up for 3~24 months.According to whether the patients had recurrent non-operative vertebral fracture after PVA,all patients were divided into fracture group and non-fracture group.In the non-fracture group,there were 51 patients,including 10 males and 41 females.The mean age was (73.3±9.7)years.In the fracture group,there were 61 patients,including 13 males and 48 females.The mean age was (75.0±8.5)years.The difference of serum vitamin D level between the two groups was analyzed.Results Postoperative follow-up was 3~24 months,There was no significant difference in sex,age,bone mineral density and mode of operation between the two groups (P>0.05),but there was significant difference in postoperative antiosteoporosis treatment (P<0.05).There was significant difference in postoperative 25-hydroxyvitamin D between fracture group and non-fracture group (P<0.05).The risk of recurrent fracture in patients without postoperative anti-osteoporosis treatment was about 4.13 times higher than that in patients with postoperative anti-osteoporosis treatment.Postoperative vitamin D supplementation and a 1 ng/ml increase in serum 25-hydroxyvitamin D reduced the risk of recurrent fracture by about 5.8%.Conclusion Regular vitamin D supplementation and anti-osteoporosis therapy after PVA can reduce the incidence of recurrent fracture after PVA.
[1]Sun X,Liu X,Wang J,et al.The effect of early limited activity after bipedicular percutaneous vertebroplasty to treat acute painful osteoporotic vertebral compression fractures[J].Pain Physician,2020,23(1):E31-E40.
[2]饶敏杰,李亦男,张功恒,等.唑来膦酸对等老年性椎体压缩骨折患者椎体成形术后骨密度的影响[J].中华全科医学,2021,19(3):383-386.
[3]宁志伟.维生素D与骨质疏松症[J].中国医学前沿杂志(电子版),2015,7(10):8-14.
[4]夏维波,章振林,林华,等.原发性骨质疏松症诊疗指南(2017)[J].中国骨质疏松杂志,2019,25(3):281-309.
[5]潘帅,郭安梅.肌筋膜疼痛综合征患者25羟基维生素D水平及危险因素分析[J].中国现代医药杂志,2021,23(2):15-19.
[6]叶佳铭,洪宝建,徐柯.女性类风湿性关节炎患者血清25-羟基维生素D2和25-羟基维生素D3的水平状况分析[J].中国卫生检验杂志,2021,31(4):441-443.
[7]Souberbielle JC,Cormier C,Cavalier E,et al.Vitamin D supplementation in france in patients with or at risk for osteoporosis:Recent data and new practices[J].Joint Bone Spine,2020,87(1):25-29.
[8]茅晓蒙,阮慧娟,杨玲,等.老年男性住院患者骨骼肌肌量与维生素D水平的相关性[J].中华老年多器官疾病杂志,2021,20(3):182-185.
[9]张萌萌,张秀珍,邓伟民,等.骨代谢生化指标临床应用专家共识(2019)[J].中国骨质疏松杂志,2019,25(10):1357-1372.
[10]谢俊杰,张灿,刘夏莹,等.血脂及血清维生素D水平预测老年女性髋部骨质疏松骨折可行性分析[J].实用骨科杂志,2021,27(3):210-214;257.
[11]Ip TP,Cheung SK,Cheung TC,et al.Osteoporosis society of Hong Kong.The osteoporosis society of Hong Kong (OSHK):2013 OSHK guideline for clinical management of postmenopausal osteoporosis in Hong Kong[J].Hong Kong Med J,2013,19(Suppl 2):1-40.
[12]廖祥鹏,张增利,张红红,等.维生素D与成年人骨骼健康应用指南(2014年标准版)[J].中国骨质疏松杂志,2014,20(9):1011-1030.
[13]祝晓雨,张伟光,赵志刚.骨质疏松症国内外药物治疗的研究现状[J].中国临床药理学杂志,2020,36(5):588-592.
[14]Holick MF,Binkley NC,BischoffFerrari HA,et al.Evaluation,treatment and prevention of vitamin D deficiency:an Endocrine Society clinical practice guideline[J].J Clin Endocrinol Metab,2011,96(7):1911-1930.
[15]Nowson CA,McGrath JJ,Ebeling PR,et al.Vitamin D and health in adults in Australia and New Zealand:a position statement[J].Med J Aust,2012,196(11):686-687.
[16]Ross AC,Taylor CL,Yaktine AL,et al.Institute of medicine (US) committee to review dietary reference intakes for Vitamin D and calcium[M].Washington (DC):National Academies Press (US),2011:21796828.