骨桥效应治疗急性骨质疏松性椎体压缩骨折：一种使用合成代谢药物的多策略方法
Bone Bridge Effect for the Treatment of Acute Osteoporotic Vertebral Compression Fractures: A Multistrategic Approach Using an Anabolic Agent.
摘要(中文译文)
探讨骨桥效应（BBE）并比较不同抗骨质疏松药物对腰椎骨质疏松性椎体压缩骨折（OVCF）患者的治疗效果。本研究随访了264例接受保守治疗超过12个月的腰椎OVCF患者。根据用药情况将患者分为四组：地舒单抗单药治疗组（D组）、特立帕肽联合地舒单抗组（TDco组）、罗莫佐单抗序贯地舒单抗组（RDse组）和双膦酸盐单药治疗组（B组）。比较从受伤至伤后1年的骨密度（BMD）变化、包括BBE在内的影像学参数及视觉模拟量表（VAS）评分。1年BBE发生率在促骨形成药物治疗组中最高：RDse组（56.3%）和TDco组（51.8%），显著高于D组（28.6%）和B组（21.1%）。TDco组的年骨密度增幅（1.04）显著大于其他各组（RDse组：0.63；D组：0.55；B组：0.35）。促骨形成药物组及确诊BBE的患者在3个月时VAS评分显著下降，提示疼痛快速缓解。多因素logistic回归分析证实，促骨形成药物组（TDco组和RDse组）是BBE形成的显著独立预测因素（比值比分别为2.717和3.472），即使在调整初始骨密度等混杂变量后仍成立。与抗骨吸收药物相比，促骨形成药物似乎与更多的BBE形成、更大的骨密度增益及更快的疼痛缓解相关。因此，对于OVCF患者，采用促骨形成药物（如TDco组和RDse组所用方案）的治疗策略可能是重要的考虑因素。
Abstract
To determine the bone bridge effect (BBE) and compare treatment outcomes of different osteoporosis medications in patients with lumbar osteoporotic vertebral compression fractures (OVCF). This study followed 264 patients with lumbar OVCFs undergoing conservative treatment for more than 12 months. Patients were divided into four groups based on medication: denosumab monotherapy (group D), teriparatide and denosumab combination (group TDco), sequential romosozumab followed by denosumab (group RDse), and bisphosphonate monotherapy (group B). Changes in bone mineral density (BMD), radiological parameters including BBE, and visual analog scale (VAS) scores were compared from injury to 1 year post-injury. The 1-year BBE incidence was highest in groups treated with anabolic agents: group RDse (56.3%) and group TDco (51.8%). These rates were significantly higher than in group D (28.6%) and group B (21.1%). The annual BMD increase was significantly greater in group TDco (1.04) compared to the other groups (RDse: 0.63; D: 0.55; B: 0.35). VAS scores decreased significantly by the 3-month mark in anabolic agent groups and in patients with confirmed BBE, indicating rapid pain relief. Multivariate logistic regression analysis confirmed that anabolic agent groups (TDco and RDse) were significant independent predictors of BBE formation (odds ratio 2.717 and 3.472, respectively), even after adjusting for confounding variables such as initial BMD. Anabolic agents appeared to be associated with more BBE formation, greater BMD gains, and faster pain reduction compared to anti-resorptive agents. Therefore, treatment strategies using anabolic agents, such as those in groups TDco and RDse, may be important considerations for treating patients with OVCFs.
如何引用
AMA
Ja-Yeong Yoon, Sung-Min Kim, Seong-Hwan Moon, Hak-Sun Kim, Kyung-Soo Suk, Si-Young Park, et al. Bone Bridge Effect for the Treatment of Acute Osteoporotic Vertebral Compression Fractures: A Multistrategic Approach Using an Anabolic Agent.. Yonsei medical journal. 2026; doi:10.3349/ymj.2025.0325.
APA
Ja-Yeong Yoon, Sung-Min Kim, Seong-Hwan Moon, Hak-Sun Kim, Kyung-Soo Suk, Si-Young Park, et al (2026). Bone Bridge Effect for the Treatment of Acute Osteoporotic Vertebral Compression Fractures: A Multistrategic Approach Using an Anabolic Agent.. Yonsei medical journal. https://doi.org/10.3349/ymj.2025.0325
GB/T 7714
Ja-Yeong Yoon, Sung-Min Kim, Seong-Hwan Moon, Hak-Sun Kim, Kyung-Soo Suk, Si-Young Park, et al. Bone Bridge Effect for the Treatment of Acute Osteoporotic Vertebral Compression Fractures: A Multistrategic Approach Using an Anabolic Agent.[J]. Yonsei medical journal, 2026 doi:10.3349/ymj.2025.0325.
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