术前副甲状腺激素 (PTH) 类似物是否能改善骨密度并减少脊柱形纠正中的机械并发症? - - 至少为期2年的放射学研究测量霍恩斯菲尔德单位
Andrew Chung1, Jerry Robinson2, David Gendelberg3
1Department of Orthopedics, Banner Health, 13995 W Statler Blvd #200, Surprise, Phoenix, AZ, 85374, USA. Andrew.chung2@bannerhealth.com.
概括
副甲状腺激素 (PTH) 类似物在接受脊柱形纠正手术的患者中改善了腰椎骨密度. 这种骨健康优化策略可能会减少机械并发症,尽管12%的患者没有看到密度增加.
科学领域:
- 整形外科 整形外科 整形外科
- 脊柱外科手术 脊柱外科手术
- 骨的新陈代谢 骨的新陈代谢
背景情况:
- 最少侵入性脊柱融合技术越来越多地用于成人脊柱形 (ASD).
- 足够的骨密度对于手术成功至关重要,并防止机械并发症,如伪关节炎和硬件故障.
- 已知甲状腺激素 (PTH) 的类似物会增加骨矿物质密度.
研究的目的:
- 为了确定在外科手术期间使用PTH模拟剂是否能改善ASD纠正患者的腰椎骨密度.
- 评估PTH类似物对骨矿物质密度和机械并发症的影响.
主要方法:
- 分析了一份前性收集的254名患者登记册,这些患者接受了ASD的CMIS纠正.
- 包括41名手术前和2年后CT扫描的患者,他们接受了PTH类似物一年.
- 腰椎骨密度 (L1-L3的霍恩斯菲尔德单位) 在手术前和后被测量.
主要成果:
- 在手术后2年 (p < 0.05) 观察到腰部骨密度 (霍恩斯菲尔德单位) 的显著改善.
- 没有发生螺丝松动或拉开;只有4.8%的患者患有伪关节炎 (PJF),这些患者没有完成PTH治疗.
- 尽管完成了PTH治疗,12%的患者没有经历骨密度增加;只有一个患者报告恶心.
结论:
- 在接受脊椎形正的患者中,PTH类型似乎是增加骨密度的有价值补充.
- 这种方法可能有助于减轻与微创脊柱手术相关的机械并发症风险.
- 需要进一步的比较研究来证实这些发现,并建立最佳的骨健康方案.
相关概念视频
01:29Bone Disorders
3.7K
Aging and its effect on bone remodeling is the most common cause of bone disorders. In young and healthy people, bone deposition and resorption happen at an equal rate to maintain optimal bone health.
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
3.7K
01:40Bone Remodeling
38.4K
Bone remodeling is a continuous and balanced process of bone resorption by osteoclasts and bone formation by osteoblasts. In adults, it helps maintain bone mass and calcium homeostasis. While mechanical stress can stimulate turnover as part of the normal maintenance and reparative process, several hormones also regulate bone remodeling.
38.4K
01:17Hormones and Bone Tissue
2.7K
The endocrine system produces and secretes hormones, which interact with the skeletal system. These hormones control bone growth, maintain bone once it is formed, and remodel it.
Hormones That Influence Osteoblasts and/or Maintain the Matrix
Several hormones are necessary for controlling bone growth and maintaining the bone matrix. The pituitary gland secretes growth hormone (GH), which, as its name implies, controls bone growth. This happens in several ways: first, it triggers chondrocyte...
Hormones That Influence Osteoblasts and/or Maintain the Matrix
Several hormones are necessary for controlling bone growth and maintaining the bone matrix. The pituitary gland secretes growth hormone (GH), which, as its name implies, controls bone growth. This happens in several ways: first, it triggers chondrocyte...
2.7K
00:59The Parathyroid Glands
2.2K
The two pairs of parathyroid glands embedded within the posterior surface of the thyroid gland are restricted by a dense capsule around them. These glands comprise two distinct cell populations—parathyroid oxyphil and parathyroid principal cells- pivotal in calcium homeostasis.
Oxyphil cells, whose functions remain elusive, emerge during late puberty, adding a layer of complexity to the parathyroid gland's intricacies. In contrast, principal parathyroid cells undertake a vital role by...
Oxyphil cells, whose functions remain elusive, emerge during late puberty, adding a layer of complexity to the parathyroid gland's intricacies. In contrast, principal parathyroid cells undertake a vital role by...
2.2K