[A clinical study of the changes of bone lesions after parathyroidectomy in patients with secondary...

We evaluated the changes of the bone lesions and their relative bone findings before and after parathyroidectomy in 23 patients with secondary hyperparathyroidism. Before the operation, all patients had bone and/or joint pain. In radiographic findings, subperiosteal bone resorption of the hand and a salt and pepper coloration of the skull were observed in all patients. Rugger jersey spine and the disappearance of the lamina dura were observed in about 90% of the patients. The bone mineral contents measured by single photon absorptiometry and digital image processing method had decreased in all of the patients compared with the mean values in sex- and age-matched controls. After the operation, the bone and/or joint pain had disappeared excluding three patients with recurrent hyperparathyroidism. The bone changes of the hand and the skull had improved in about 90% of the patients. However, the improvement rate was low in the vertebral and dental bone changes. The bone mineral contents increased significantly compared with the preoperative values. In recurrent cases, transient increase of the bone mineral contents was observed postoperatively. However, their values, were decreased gradually with the elevation of parathyroid hormone level. The evaluation of the bone lesions before and after parathyroidectomy not only indicates the effectiveness of the operation but also illustrates the function of the autotransplanted parathyroid tissues. We conclude that regular examination of the bone lesions after parathyroidectomy, paying attention to recurrent hyperparathyroidism and/or graft function, is mandatory.