Analysis Of Diagnosis And Treatment Of Osteoporosis In Patients With Lumbar Degenerative Diseases

Objective To retrospectively analyze the preoperative bone mineral density,bone turnover markers,serum 25-hydroxyvitamin D detection and treatment of osteoporosis in patients with lumbar degenerative diseases.Methods Preoperative bone mineral density,bone conversion markers,serum25-hydroxyvitamin D detection and treatment of osteoporosis were recorded in 516 patients with lumbar degenerative disease aged ≥50 years.The patients with bone mineral density were divided into ≥60 years group and < 60 years group.Patients who received serum 25-hydroxyvitamin D and bone mineral density tests at the same time were divided into the serum 25-hydroxyvitamin D≥20ng/ml group and the serum25-hydroxyvitamin D < 20ng/ml group,and the difference in the prevalence of osteoporosis between the two groups was analyzed.The patients who were tested for markers of bone transformation were divided into the elevated group and the normal group,and the difference in the prevalence of osteoporosis between the two groups was analyzed.Results Among the 516 patients,139(26.9%)were tested for bone mineral density,including 65(46.76%)patients with osteoporosis and 61(43.88%)patients with bone mass loss.A total of 109 patients(21.12%)were tested for serum 25-hydroxyvitamin D.39 patients(35.78%)had adequate serum 25-hydroxyvitamin D,48(44.04%)had insufficient serum 25-hydroxyvitamin D,and 22(20.18%)had insufficient serum25-hydroxyvitamin D.There was no statistical difference in the osteoporosis rate between the serum 25-hydroxyvitamin D≥20ng/ml group and the serum25-hydroxyvitamin D < 20ng/ml group(P= 0.549).A total of 109 patients(21.12%)were tested for bone conversion markers.There was no statistical difference in the prevalence of osteoporosis between the group with increased bone conversion markers and the normal group(P=0.097,P=0.279).Among the 65 patients diagnosed with osteoporosis,14(21.54%)had no drug treatment,and 12(18.46%)had basic treatment with calcium and/or common vitamin D alone.Among the 39(60%)patients treated with anti-osteoporosis,33(50.76%)were treated with bisphosphonates,and 6(9.23%)were treated with active vitamin D or calcitonin alone.Conclusions Patients with degenerative diseases of the lumbar spine had a high prevalence of preoperative osteoporosis,a low diagnosis rate,and a low treatment rate,as well as a low detection rate of bone conversion markers,serum 25-hydroxyvitamin D,and a high rate of serum 25-hydroxyvitamin D deficiency.