类风湿性关节炎(RA)是一种慢性系统性自身免疫性疾病,RA的主要并发症之一是骨质疏松,这可能会导致骨质疏松性椎体压缩骨折(OVCF),从而导致下腰痛和脊柱变形。对于患有OVCF的RA患者,骨质疏松症的症状更严重,如果要进行手术治疗,重视RA引起的骨质疏松的治疗。
■我们报告了一例68岁女性RA和连续性骨质疏松性椎体骨折,采用经皮椎体成形术(PVP)和经皮椎体后凸成形术(PKP)治疗。患者经历了3次自发性多次OVCF:在5个月的过程中,她接受了1次PKP和2次PVP手术,从第一至第五腰椎分别接受了5个水泥增强椎骨。每次手术之间的平均间隔为75天(范围,2-3个月)。病例报告使我们对每个阶段的治疗进行了研究,并思考了原因,我们对RA引起的OVCFs的治疗进展进行了综述,以便将来我们可以为类似的患者选择更好的方法。
■对于无神经损伤的RA继发OVCF,如果我们进行手术治疗,系统的治疗,包括RA治疗,疼痛管理,支具处理,和抗骨质疏松措施很重要。其中,抗骨质疏松治疗具有最高优先级,因为RA引起的骨质疏松具有可逆性。
UNASSIGNED: Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease, and one of the main complications of RA is osteoporosis, which can cause osteoporotic vertebral compression fractures (OVCFs) that lead to low back pain and spinal deformation. For RA patients with OVCFs, the symptoms of osteoporosis are more severe, if surgical treatment is to be carried out, it is important to focus on the treatment of osteoporosis caused by RA.
UNASSIGNED: We report a
case of a 68-year-old woman with RA and successional osteoporotic vertebral body fractures treated by percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP). The patient experienced spontaneous multiple OVCFs on three occasions: in the course of 5 months, she underwent one PKP and two PVP operations with five cement-augmented vertebrae from the first to fifth lumbar vertebrae. The mean interval between each operation was 75 days (range, 2-3 months). The
case report makes us look into the treatment of each stage and think about the reasons, we reviewed the literatures on advancements in the treatment of OVCFs caused by RA, so that we can choose a better method for similar patients in the future.
UNASSIGNED: For OVCFs secondary to RA without neurological damage, if we carry out surgical treatment, the systematic treatments, including RA treatment, pain management, brace treatment, and anti-osteoporosis measures are important. among them, anti-osteoporosis treatment has the highest priority because of the reversible nature of osteoporosis caused by RA.