Clinical features of reparative regeneration of bone tissue and optimization of treatment for compression fractures of the thoracic and lumbar vertebral bodies against the background of postmenopausal and senile osteoporosis

D. V. Ivchenko, V. V. Miroshnikov

DOI: http://dx.doi.org/10.12775/JEHS.2020.10.11.015

Abstract


Introduction. Bone-destructive processes and injuries of the vertebral bodies of the thoracic and lumbar localization are a significant part of the pathology of this localization. According to etiological factors, mechanisms of pathogenesis and the nature of the course, they are a very heterogeneous groups of diseases.

Objective: to identify the main factors that determine the development of disorders in compression fractures of vertebral bodies of thoracic and lumbar localization against the background of postmenopausal and senile osteoporosis for improving the prognostic criteria of the disease on the basis of an integrated assessment of the clinical course of the disease and optimizing treatment by activating reparative bone tissue regeneration according to the literature sources analyzed.

Material and research methods. Depending on the treatment method used, patients were divided into 3 groups: in group 1 (control group) were 20 patients with compression fractures of vertebrae of thoracic and lumbar localization against a background of postmenopausal and senile osteoporosis, where we used standard methods of therapy. Group 2 (main group) consisted of 20 patients with compression fractures of vertebrae of thoracic and lumbar localization against the background of postmenopausal and senile osteoporosis, in the treatment of which platelet-rich plasma was also used in addition to standard methods of therapy.

Research results. Based on the obtained results of the study, we developed an algorithm for surgical treatment of patients with pathological vertebral fractures against the background of osteoporosis. The choice of the method of surgical treatment depends on: the type of fracture, the level of damage, the degree of loss of bone mineral density, the degree of deformation of the spine, the general somatic state of the patient, the presence of stenosis of the spinal canal and signs of neurological deficit, the severity of the pain syndrome.

Conclusion. The introduction of platelet-rich plasma to the area of the bone wound shortens the duration of the healing process, in our opinion, by eliminating the phase of inflammation, low intensification of the phase of formation of tissue-specific elements that are present in large amount in platelet growth factors. In order to accelerate the restoration of damaged bone, we used a platelet-rich plasma in addition to standard therapy, and found a positive effect on compressive fractures of the thoracic and lumbar vertebrae against the background of postmenopausal and senile osteoporosis, which justifies the advisability of further use platelet-rich plasma in clinical practice.


Keywords


Platelet-Rich Plasma; reparative regeneration; osteogenesis; bone remodeling; mineral metabolism; osteoporosis

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References


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