OBJECTIVE: To evaluate the analgesic effect and application advantage of acupuncture combined with local anesthesia of lidocaine in percutaneous vertebroplasty (PVP) for the patients with osteoporotic vertebral compression fracture (OVCF). METHODS: A total of 60 patients with OVCF and receiving PVP at single vertebra under local anesthesia were selected and randomized into an acupuncture plus medication group and a simple medication group, 30 cases in each one. In the simple medication group, the local laying infiltration anesthesia with 1% lidocaine 30 mL was used. In the acupuncture plus medication group, firstly, filiform needles were used to stimulate Hegu (LI 4), Neiguan (PC 6), Jinmen (BL 63) and Yintang (GV 29) with reducing technique, and then the epidermal infiltration anesthesia was followed with 1% lidocaine 4 mL. The needles were retained till the end of operation. Successively, before operation (T RESULTS: In the acupuncture plus medication group, MAP and HR were lower than those in the simple medication group at T CONCLUSION Acupuncture combined with medication reduces the dose and adverse reactions of anesthetics, alleviates pain degree of patients, shortens the duration of operation and improves patients' subjective satisfaction in PVP for OVCF.
Analgesics ; Fractures, Compression/therapy* ; Humans ; Osteoporotic Fractures ; Spinal Fractures/therapy* ; Spine ; Treatment Outcome

Humans ; Fractures, Compression/surgery* ; Spinal Fractures/surgery* ; Multiple Myeloma/drug therapy* ; Vertebroplasty ; Osteoporotic Fractures/therapy* ; Treatment Outcome ; Bone Cements

No abstract available.
Aging ; Health Knowledge, Attitudes, Practice ; Hip Fractures/*prevention & control/therapy ; Humans ; Osteoporosis/*drug therapy ; Osteoporotic Fractures/*prevention & control/therapy

OBJECTIVES: A retrospective study was performed to clarify the change of lumbar bone mineral density(BMD) according to the duration of hormone replacement therapy(HRT) and the other factors such as age, years since menopause(YSM) and initial BMD in postmenopausal women. METHODS: From January, 1995 to December, 1998 we measured lumbar bone mineral density in 100 postmenopausal women in the department of obstetrics and gynecology, Inha University Hospital. These women had been followed for 2 years after taking HRT. We investigated whether there were any relation between the duration of HRT, age, YSM, initial BMD and change of BMD. RESULTS: Lumbar BMD was increased 2.06% after one year of HRT(p=0.0001) but there was no change of BMD at the 2nd year of HRT(p=0.847). The response to HRT was greatest in those who were oldest(r=0.209 ; p=0.039) and furthest YSM(r=0.209; p=0.039), and consequently among those who had the lowest BMD(r=0.590 ; p=0.0001). CONCLUSION: The bone mass was increased upto 2.06% at the 1st year of HRT but no more progressive increase was occurred. It suggest that intensive HRT is needed at 1st year of therapy. The risk of fracture is not decreased to that of the healthy population inspite of HRT, so the earlier therapy is necessary to prevent osteoporotic fracture despite of intervention.
Bone Density* ; Female ; Gynecology ; Hormone Replacement Therapy* ; Humans ; Obstetrics ; Osteoporotic Fractures ; Retrospective Studies

Postmenopausal osteoporosis is a kind of degenerative disease, also described as "invisible killer." Estrogen is generally considered as the key hormone for women to maintain bone mineral content during their lives. Iron accumulation refers to a state of human serum ferritin that is higher than the normal value but less than 1000 μg/L. It has been found that iron accumulation and osteoporosis could occur simultaneously with the decrease in estrogen level after menopause. In recent years, many studies indicated that iron accumulation plays a vital role in postmenopausal osteoporosis, and a significant correlation has been found between iron accumulation and fragility fractures. In this review, we summarize and analyze the relevant literature including randomized controlled trials, systematic reviews, and meta-analyses between January 1996 and July 2022. We investigate the mechanism of the effect of iron accumulation on bone metabolism and discuss the relationship of iron accumulation, osteoporosis, and postmenopausal fragility fractures, as well as the main clinical treatment strategies. We conclude that it is necessary to pay attention to the phenomenon of iron accumulation in postmenopausal women with osteoporosis and explore the in-depth mechanism of abnormal bone metabolism caused by iron accumulation, in order to facilitate the discovery of effective therapeutic targets for postmenopausal osteoporosis.
Humans ; Female ; Osteoporotic Fractures ; Osteoporosis, Postmenopausal/drug therapy* ; Postmenopause ; Osteoporosis ; Bone Density ; Estrogens ; Iron/therapeutic use*

OBJECTIVETo evaluate the clinical efficacy of manipulative reduction combined with percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty (PKP) in treating osteoporotic vertebral compression fracture (OVCF) using meta-analysis method, in order to provide a reference for clinical treatment.

METHODSA systematic computer-based search (from January 1987 to April 2014) from CNKI, Wanfang database, Web of Science and PubMed were performed for the collection of controlled clinical researches on manipulative reduction combined with PVP or PKP in treating OVCF. The quality of selected researches was evaluated. Meta-analysis was adopted to evaluate visual analog scale, Cobb angle, anterior height ratio of the injured vertebra.

RESULTSA total of 7 researches of 410 patients were included in the present analysis, there were 5 RCTs and 2 non-RCTs and all come from China. Manipulative reduction combined with PVP could got better improvement in Cobb angle (WMD=-7.35; 95%CI: -12.15, -2.54) and anterior height ratio of the injured vertebra (P<0.01) than simple PVP, but no significant difference was found in improvement of visual analog scale (WMD=-0.01; 95%CI: -0.45, 0.42). There were no significant differences in the improvement of visual analog scale, Cobb angle, anterior height ratio of the injured vertebra between manipulative reduction combined with PKP and simple PKP (P>0.05).

CONCLUSIONCompared with simple PVP, manipulative reduction combined with PVP may result in more clinical efficacy on the improvement of Cobb angle and anterior ratio of the injured vertebra. And compared with simple PKP, manipulative reduction combined with PKP has no obvious advantages on the improvement of visual analog scale, Cobb angle, anterior height ratio of the injured vertebra. However, the number and quality of the literatures, may resulted in the effect of mistrust, so more large sample and high-quality RCTs are needed in future.

Combined Modality Therapy ; Fractures, Compression ; therapy ; Humans ; Manipulation, Spinal ; methods ; Minimally Invasive Surgical Procedures ; methods ; Osteoporotic Fractures ; therapy ; Spinal Fractures ; therapy

STUDY DESIGN: A review of related literature regarding the prevention of osteoporotic fractures. OBJECTIVES: To discuss the customized treatment and prevention of osteoporotic fracture. SUMMARY OF LITERATURE REVIEW: Various customized treatments for osteoporosis have been discussed. MATERIALS AND METHODS: Review of related literatures. RESULTS: It would be best to individualize medications based on each patient's sex, age, bone density in the spine and hip bones, presence or absence of drug over-use for underlying comorbidities, presence or absence of a gastrointestinal disease, duration of bisphosphonate usage, and presence or absence of an adverse effect, and drug efficacy according to the analysis of follow-up bone density, and compliance. CONCLUSIONS: Pharmacotherapy should be combined with various prophylactic therapies to prevent osteoporotic fractures. Various factors should be considered as well before selecting an osteoporosis medication. Different types of medications may have different effects in their ability to reduce fracture risk in patient with different bone densities and other characteristics.
Bone Density ; Comorbidity ; Compliance ; Drug Therapy ; Follow-Up Studies ; Gastrointestinal Diseases ; Hip ; Humans ; Osteoporosis ; Osteoporotic Fractures* ; Spine

Osteoporosis is characterized by low bone mass and microarchitectural deterioration of bone tissue, with subsequent increase in bone fragility and susceptibility to fracture and is one of the most significant long term sequelae of menopause. Hormone replacement therapy(HRT) with estrogen combined with or without progestogen has been the treatment of choice for preventing bone loss in postmenopausal women and epidemiologic data have confirmed that it reduces the incidence of osteoporotic fracture. Even though the use of accepted bone sparing doses of estrogen it has been presented that some proportion of postmenopausal women actually decrease bone mineral density(BMD). The purpose of this study were to evaluate the incidence of subjects with loss of BMD and the factors influencing BMD changes in these subjects compared with those of subjects with increased BMD assessed by quantitative computed tomograpy(QCT) according to age, the duration of menopaue, the baseline BMD, the bone turnover state, the type of menopause, the mode of HRT. This study who undergone in 128 postmenopausal women who were treated with HRT checked BMD by QCT for 1 year and pre-HRT and post-HRT from March 1993 to May 1995 in Chung-Ang University hospital. The results were as follows 1)The overall incidence of subjects with loss of BMD after 1 year of HRT was 33.5%. 2)The incidence of subjects with significant loss of BMD was 27.3%. 3)The comparison between the subjects with decreased and increased BMD proved significant differences(p < 0.05) in age, menopausal duration, baseline BMD and alkaline phosphatase levels. the subjects with decreased BMD after HRT were younger, closer to the menopause, had a higher baseline BMD levels and lower bone-turnover status. 4)Twenty-one out of 92 subjects with natural menopause showed decreased BMD after HRT, which comprised 22.8%. Meanwhile among the 36 subjects with surgical menopausal, 22 women, comprising 61.1%, had decreased BMD. 5)The incidence of postmenopausal women with decreased or significant decreased in BMD after HRT were the highest in normal bone status group and lower in osteoporotic group. 6)Among the subjects treated estrogen only, 62.1% showed decrease in BMD whereas 25.3% of the subjects treated with with combined estrogen and progest-ogen regimen showed decreased BMD.
Alkaline Phosphatase ; Bone and Bones ; Bone Density* ; Estrogen Replacement Therapy* ; Estrogens ; Female ; Humans ; Incidence ; Menopause ; Osteoporosis ; Osteoporotic Fractures

INTRODUCTION: A significant treatment gap has been observed in patients with osteoporosis. Our previous audit found a 31.5% rate of anti-osteoporosis medication initiation after fragility fractures at one year. We piloted the use of telecarers to monitor osteoporosis treatment and compliance. METHODS: From January 2017 to January 2018, all hip fracture patients at Changi General Hospital, Singapore, were automatically enrolled into the Health Management Unit valued care hip fracture programme. Telecarer calls were scheduled at discharge, 3, 6 and 12 months. We assessed the acceptability, completion and treatment rates of patients enrolled in this programme. RESULTS: A total of 537 patients with a hip fracture were enrolled in the telecarer programme over one year. Their average age was 79.8 ± 8.23 years, and 63.1% of them were female. A total of 341 patients completed 12 months of follow-up, of which 251 (73.6%) patients were on treatment at 12 months. The most common cause of lack of initiation of secondary osteoporosis treatment was patient or family rejection (34.4%), followed by physician failure to prescribe (24.4%) and renal impairment (24.4%). 16.7% of patients were deemed to have advanced dementia with a life-limiting illness and were, thus, deemed unsuitable for treatment. CONCLUSION Telecarers may be a useful adjunct in the monitoring of osteoporosis treatment after hip fractures in an elderly population. The main limitations are patient or family rejection and physician inertia. Further studies should focus on a combination of interventions for both patients and physicians to increase awareness of secondary fracture prevention.
Humans ; Female ; Aged ; Aged, 80 and over ; Male ; Osteoporotic Fractures/drug therapy* ; Bone Density Conservation Agents/therapeutic use* ; Osteoporosis/drug therapy* ; Hip Fractures/etiology* ; Secondary Prevention

To study the clinical application of Jintian'ge capsule in treatment of vertebral compression fracture in senile osteoporosis patients. In the study, 69 senile osteoporotic vertebral compression fracture patients hospitalized in our hospital between January 2012 and June 2014 were selected and randomly divided into the control group and the treatment group. Patients in the control group were treated by percutaneous kyphoplasty (PKP), while those in the treatment group were given Jintian'ge capsule in addition to PKP. Efforts were made to visit the patients before the surgery and in three month after that, observe and compared the vertebral height, Cobb's angle, bone density, visual analogue scale (VAS) and Oswestry disability index between patients in the two groups. According to the findings, compared with before the treatment, patients in the two groups showed significant improvements in the vertebral height, Cobb's angle, bone density, VAS and Oswestry disability index three months after the surgery (P < 0.05); During the visit three months after the treatment, compared with the control group, the treatment group showed notable increases in all parameters (P < 0.05), particularly in the vertebral height, VAS and Oswestry disability index (P < 0.05). Based on the above findings, Jintian'ge capsule is applicable in adjuvant therapy after the osteoporotic vertebral compression facture PKP surgery.
Drugs, Chinese Herbal ; administration & dosage ; Female ; Fractures, Compression ; drug therapy ; etiology ; Humans ; Male ; Middle Aged ; Osteoporosis ; complications ; Osteoporotic Fractures ; drug therapy ; etiology ; Spinal Fractures ; drug therapy ; etiology ; Treatment Outcome