Effect of teriparatide combined with elcatonin on the clinical efficacy after endoscopic lumbar interbody fusion in patients with osteoporosis

English Keywords:Osteoporosis  Teriparatide  Elcatonin  Endoscopic lumbar interbody fusion

English Abstract:

  【Abstract】 Objectives: To observe the effect of teriparatide and elcatonin on the efficacy of endoscopic lumbar interbody fusion(Endo-LIF) in patients with osteoporosis. Methods: A total of 60 patients diagnosed with lumbar spinal stenosis combined with osteoporosis undergone Endo- LIF via posterior transforaminal approach (Endo-P/TLIF) in Foshan Jianxiang Orthopedics Hospital between July 2021 and February 2023 were collected. Among the patients, 30 treated with vitamin D + calcium + elcatonin for 3 months after operation were included in the control group(6 males, 24 females, aged 67.0±6.6 years; 12 involved single segments, 18 involved double segments); 30 treated with teriparatide + elcatonin + vitamin D + calcium for 3 months after operation were included in the observation group(7 males, 23 females, aged 66.0±5.9 years; 10 involved single segments, 20 involved double segments). There were no statistical differences in age, sex ratio, bone mineral density(BMD) before treatment and surgical segments between the two groups(P>0.05). The visual analogue scale(VAS) score, Oswestry disability index(ODI), and systemic bone metabolism indexes[P1NP, β -CTX, BGP, 2,5(OH)VitD] were counted before and at 1 month and 3 months after treatment. The intervertebral body fusion at 3 months after treatment, and the T values of BMD before and at 6 months after treatment were also collected and evaluated. A t-test or chi-square test was applied to compare the differences between the two groups. Results: There were no statistical differences in VAS scores, ODIs, bone metabolism indexes, and T values of BMD between the two groups before treatment(P>0.05). At 1 and 3 months after treatment, the VAS scores and ODIs were significantly reduced in both groups, with the decrease in the observation group more significantly than that in the control group at the same time point(P<0.05). P1NP, β-CTX, BGP and 2,5(OH)VitD in the observation group were significantly higher at 1 and 3 months after treatment compared with before treatment(P<0.05). BGP and 2,5(OH)VitD in the control group increased significantly at 3 months after treatment compared with before treatment(P<0.05). P1NP, β-CTX and BGP were higher in the observation group than in the control group at 3 months after treatment(P<0.05). There was no statistical difference in 2,5(OH)VitD at the same time point between the two groups(P>0.05). The intervertebral fusion rate in the observation group was significantly higher than that of the control group at 3 months after treatment(96.66% vs 80.00%, P<0.05). The T value of BMD in the observation group was significantly higher than in the control group at 6 months after treatment(-2.76±0.37 vs 3.06±0.42, P<0.05). Conclusions: Teriparatide combined with elcatonin can improve the clinical symptoms, bone mineral density, and systemic bone metabolism index changes, and enhance early interbody fusion rate after Endo-P/TLIF in osteoporosis patients.