目的 分析姜黄素在抑制脊柱黄韧带骨化过程中血管增生的应用价值.方法 选取40 只脊柱黄韧带骨化大白兔为研究对象,将所有大白兔按照随机数字表法分为对照组 2、试验组 2、试验组 1、对照组 1,每组 10 只.试验组 1 植入含姜黄素的复合载体,对照组 1 植入含磷酸盐缓冲液(PBS)的复合载体,试验组 2 灌胃姜黄素,对照组 2 灌胃生理盐水.在持续干预 4 周后检查四组大白兔的黄韧带血管增生情况,比较四组血管内皮生长因子(VEGF)、基质金属蛋白酶-9(MMP-9)、微血管密度(MVD)、白细胞介素-6、超氧化物歧化酶、丙二醛、甘油三酯、低密度脂蛋白胆固醇、总胆固醇、高密度脂蛋白胆固醇、p53、Caspase-3 水平.结果 四组VEGF、MMP-9 水平由高到低为:对照组 2>试验组2(对照组 1)>试验组 1,差异均具有统计学意义(P<0.05);但试验组 2 与对照组 1 比较,差异无统计学意义(P>0.05).对照组 2 白细胞介素-6(827.53±59.86)ng/L均高于试验组 2 的(715.41±50.81)ng/L、对照组 1 的(713.58±47.64)ng/L、试验组 1 的(642.88±40.21)ng/L,且试验组 1 均低于试验组 2 和对照组 1,试验组 1 超氧化物歧化酶(652.63±150.43)μg/L均高于对照组 2 的(273.68±70.59)μg/L、试验组 2 的(224.74±56.55)μg/L、对照组 1 的(225.28±54.17)μg/L,试验组 1 的丙二醛(2.22±0.34)μmol/L均低于对照组 2 的(6.63±1.53)μmol/L、试验组 2 的(12.98±2.62)μmol/L、对照组 1 的(11.75±2.54)μmol/L,且对照组2 均低于试验组 2 和对照组 1,差异具有统计学意义(P<0.01).对照组 2 甘油三酯、低密度脂蛋白胆固醇、总胆固醇水平均高于试验组 2、对照组 1、试验组 1,高密度脂蛋白胆固醇均低于试验组 2、对照组 1、试验组 1,差异具有统计学意义(P<0.01).通过电镜检查结果显示试验组 1 存在明显的平滑肌细胞凋亡,其凋亡基因p53(0.6887±0.2385)、Caspase-3(1.4087±0.1628)均高于对照组 2 的(0.3941±0.2082)、(0.4487±0.1102),试验组 2 的(0.4071±0.1439)、(0.9656±0.1183),对照组 1 的(0.4068±0.1447)、(0.9671±0.1159),差异具有统计学意义(P<0.01).结论 姜黄素对脊柱黄韧带骨化过程中血管增生具有抑制作用,分析其原因可能是姜黄素能够抑制VEGF、MMP-9 的表达,抑制脊柱黄韧带的发生发展.

BackgroundExtraosseous Ewing's sarcoma/primary neuroectodermal tumor (EES/PNET) is a rare, malignant, small round blue cell tumor, which usually involves the larynx, kidneys, and esophagus. The most common metastatic sites are lung and bone. The incidence of epidural EES/PNET was 0.9%, and a detailed search of the PubMed literature found only 7 case reports of epidural ESS/PNET at the cervicothoracic junction in children. Case descriptionWe report a case of epidural ESS/PNET at the cervicothoracic junction in a child with chest and back pain as the first symptom, which worsened after half a year and developed incomplete paralysis of both lower extremities and urinary incontinence. She underwent emergency surgery, chemotherapy and radiotherapy, and died of lung metastases 8 months after surgery. ConclusionPrimary epidural tumors are mostly benign, such as spinal meningiomas and neuromas. Contrary to what has been previously thought, we report a case of malignant epidural EES/PNET at the cervicothoracic junction without bone destruction; The rarity of epidural EES/PNET at the cervicothoracic junction in children has led to a lack of data, particularly on prognostic factors and recurrence patterns. Due to the difficulty of early diagnosis and high mortality, spine surgeons must explore and increase their awareness of this disease.

目的 探讨唑来膦酸对老年性骨质疏松椎体压缩骨折患者椎体成形术后骨密度、骨代谢的影响,为临床治疗提供依据.方法 选取2019年1月-2019年12月在宜春市人民医院骨科应用经皮椎体成形术治疗的老年骨质疏松椎体压缩性骨折患者92例,采用数字随机法将92例患者分为对照组和治疗组,对照组48例,治疗组44例.对照组患者行椎体成形术后给予骨化三醇联合维生素D治疗;治疗组患者行椎体成形术后给予骨化三醇、维生素D及唑来膦酸治疗.比较2组患者治疗前、治疗后的VAS评分及Oswestry功能障碍指数评分(ODI);并比较2组患者治疗前、治疗后的腰椎骨密度及骨钙素(BGP)指标变化.结果 所有患者均顺利完成椎体成形手术.治疗前,2组患者VAS、ODI、腰椎骨密度、骨钙素差异均无统计学意义(均P ＞0.05);治疗后,2组患者VAS、OD1均明显下降(均P＜0.05),且治疗组明显优于对照组(均P ＜0.05).治疗前,2组患者腰椎骨密度、血清骨钙素差异无统计学意义(均P ＞0.05);治疗后,2组患者腰椎骨密度、血清骨钙素均明显升高(均P ＜ 0.05),且治疗组明显优于对照组(均P＜0.05).结论 唑来膦酸联合椎体成形术治疗老年骨质疏松椎体压缩性骨折疗效良好,能有效改善患者骨质疏松症状,提高患者骨密度及骨代谢指标.

目的 探讨经皮椎间孔镜髓核摘除术治疗腰椎间盘突出症的临床疗效.方法 回顾性分析自2015-02-2016-02采用经皮椎间孔镜髓核摘除术治疗的43例腰椎间盘突出症,比较术前与末次随访时疼痛VAS评分及JOA评分.结果 43例均获得随访,随访时间42～54个月,平均50.2个月.1例术后髓核部分残留,并压迫神经根,1例术后第5天出现一过性神经根性痛觉过敏,2例术后再发椎间盘突出,对症治疗后均治愈.末次随访时疼痛VAS评分较术前低,JOA评分较术前高,差异有统计学意义(P＜0.05).末次随访时疗效按改良MacNab标准进行评价:优16例,良20例,可4例,差3例,优良率83.7％.末次随访时43例复查MRI显示36例突出的椎间盘髓核完全摘除,术前Pfirrmann等级均为Ⅲ级,末次随访时32例恢复至Pfirrmann Ⅱ级,4例仍为Pfirrmnann Ⅲ级;7例存在不同程度的椎间盘残存,其中1例术后症状缓解不明显,其余6例均无神经根压迫症状,7例术前Pfirrmnann等级均为Ⅱ级,末次随访时1例恢复至Pfirrmann Ⅱ级,6例仍为Pfirrmnann Ⅱ级.结论 经皮椎间孔镜髓核摘除术是治疗腰椎间盘突出症的一种有效手术方式,其中期临床疗效满意.

目的 分析活血通络法对股骨头坏死患儿下肢微循环和血液黏度的影响.方法 选取2015年2月-2019年3月宜春市人民医院收治的50例股骨头坏死患儿为研究对象,根据治疗方式分为对照组和观察组,每组25例.对照组给予常规股骨头坏死治疗,观察组给予活血通络法治疗.比较两组的疗效,治疗前后的足甲襞微循环指标和血液黏度指标.结果 治疗后3个月和6个月,观察组总优良率均显著高于对照组,差异均有统计学意义(均P＜0.05).治疗前,两组足甲襞微循环指标和血液黏度指标比较差异均无统计学意义(均P＞0.05).治疗后1个月和3个月,两组足甲襞微循环指标和血液黏度指标比较差异均有统计学意义(均P＜0.05).结论 活血通络法在股骨头坏死患儿中的应用效果较好,且对下肢微循环及血液黏度的改善更有效,应用价值较高.

目的 探讨颈前路混合减压融合术治疗多节段脊髓型颈椎病的中期临床效果及其并发症分析.方法 回顾性分析2013年9月至2017年10月,行颈前路混合减压融合手术治疗的多节段脊髓型颈椎病36例患者资料,男21例,女15例,年龄43～71岁,平均为(52.8±2.7)岁,对所有患者进行随访,采用疼痛视觉模拟评分(VAS)评估颈肩肢体疼痛情况,日本骨科协会(JOA)评分评估患者神经功能恢复情况,生活质量评价量表(SF-36)整体评价患者手术疗效,行颈椎正侧位及过伸过屈位X线片,观察钛网等内固定情况,测量颈椎高度和颈椎生理曲度,评估植骨融合情况.并记录患者手术相关并发症.结果 34例患者获得随访,随访时间为36～72个月,平均随访时间为(50.8±4.1)个月.术前VAS为(6.9±2.2)分,高于末次随访时的(1.7±0.4)分(P＜0.001).术前JOA评分为(6.7±2.4)分,低于末次随访时的(14.8±3.6)分(P＜0.001).末次随访SF-36评分为(68.2±1.7)分,高于术前的(31.9±3.3)分(P＜0.001).至末次随访时,患者颈椎椎体高度及颈椎曲度较术前均有明显改善(P＜0.001).2例患者出现内固定松动、移位,融合率为94.1％,邻近节段退变6例,螺钉断裂1例.结论 颈前路混合减压融合手术治疗多节段脊髓型颈椎病,能有效恢复颈椎高度和维持颈椎曲度,是治疗多节段脊髓型颈椎病较为理想的手术方式之一.

Background: trans-Resveratrol has been extensively investigated for its anti-inflammatory, antioxidant, and anti-psychiatric properties. However, whether it could rescue posttraumatic stress disorder-like stress-induced pain abnormality is unknown. Aim: The present study examined the effects of trans-resveratrol on anxiety-like behavior and neuropathic pain induced by single-prolonged stress, which is a classical animal model for mimicking posttraumatic stress disorder. Methods: The single-prolonged stress-induced anxiety-like behavior and pain response were detected by the novelty suppressed feeding, marble burying, locomotor activity, von Frey, and acetone-induced cold allodynia tests in mice. The serum corticosterone levels and glucocorticoid receptor, protein kinase A, phosphorylated cAMP response element binding protein, and brain-derived neurotrophic factor expression were detected by enzyme-linked immunosorbent assay and immunoblot analyses. Results: trans-Resveratrol reversed single-prolonged stress-induced increased latency to feed and the number of marbles buried in the novelty suppressed feeding and marble burying tests, but did not significantly influence locomotion distance in the locomotor activity test. trans-Resveratrol also reversed single-prolonged stress-induced cold and mechanical allodynia. Moreover, single-prolonged stress induced abnormality in the limbic hypothalamus-pituitary-adrenal axis was reversed by trans-resveratrol, as evidenced by the fact that trans-resveratrol reversed the differential expression of glucocorticoid receptor in the anxiety- and pain-related regions. In addition, trans-resveratrol increased protein kinase A, phosphorylated cAMP response element binding protein, and brain-derived neurotrophic factor levels, which were decreased in mice subjected to single-prolonged stress. Conclusions: These results provide compelling evidence that trans-resveratrol protects neurons against posttraumatic stress disorder-like stress insults through regulation of limbic hypothalamus-pituitary-adrenal axis function and activation of downstream neuroprotective molecules such as protein kinase A, phosphorylated cAMP response element binding protein, and brain-derived neurotrophic factor expression.

目的:探讨颈前路手术治疗4个节段脊髓型颈椎病的中期临床效果及其并发症分析.方法:回顾性分析2013年9月～2016年10月,行颈椎前路手术治疗的4个节段脊髓型颈椎病31例患者资料,男18例,女13例,年龄54 ～74岁,平均58.1±4.9岁,对所有患者进行随访,采用疼痛视觉模拟评分(visual analogue scale,VAS)评估颈肩肢体疼痛情况,日本骨科协会(Japanese Orthopedic Association,JOA)评分评估患者神经功能恢复情况,行颈椎正侧位及过伸过屈位X线片,观察钛网等内固定情况,测量C2～C7颈椎椎体高度和颈椎生理曲度,评估植骨融合情况.并记录患者手术相关并发症.结果:27例患者获得随访,随访时间为35～72个月,平均52.7±3.6个月.末次随访时VAS为1.6±0.6分,低于术前的7.2±1.5分,差异有统计学意义(P＜0.001).末次随访JOA评分为16.1±4.2分,高于术前的8.8±3.7分,差异有统计学意义(P＜0.001).至末次随访时,患者颈椎椎体高度及颈椎曲度较术前均有明显改善,差异有统计学意义(P＜0.001).所有患者均获得骨性融合,27例患者共出现19例次并发症,脑脊液漏3例,一过性吞咽困难2例,轴性症状1例,C5神经根麻痹2例,邻近节段退变6例,钛网下沉2例,内固定松动、移位2例,螺钉断裂1例.结论:颈前路手术治疗脊髓前方受压为主的4个节段脊髓型颈椎病,能有效恢复颈椎高度和维持颈椎曲度,其中期疗效满意.

目的:探讨经伤椎置钉短节段固定治疗胸腰段脊椎骨折合并脊髓神经损伤的可行性和效果.方法:选取2017年4月-2018年4月在本院接受治疗的胸腰段脊椎骨折合并脊髓神经损伤患者96例.按照随机数字表法将其分为研究组和对照组,各48例.研究组采用经伤椎置钉短节段固定手术治疗,对照组采用传统经伤椎手术方法.比较两组治疗情况、治疗效果及疼痛评分.结果:研究组治疗总有效率为95.8％,高于对照组的77.1％(P＜0.05);研究组手术时间、住院时间、术中出血量均少于对照组,差异均有统计学意义(P＜0.05);研究组术后疼痛评分低于对照组(P＜0.05).结论:在胸腰段脊椎骨折合并脊髓神经损伤患者的临床治疗过程中,使用经伤椎置钉短节段固定治疗方法能够显著提高患者的治疗效果,改善治疗情况,值得在临床上进一步推广应用.

目的 探讨后路全椎体截骨矫形(VCR)治疗重度脊柱畸形的矫形效果及安全性.方法 对我院2015年3月～2017年3月收治的重度脊柱畸形患者60例进行回顾性分析.所有入选患者均于手术前后行站立位全脊柱正侧位X片,术后对患者随访6～22个月.评估术前术后患者冠状面主弯Cobb角、矢状面后凸Cobb角、C7PL-CSVL、SVA等影像学相关参数,采用Barthel指数与疼痛视觉模拟评分(VAS)评估临床效果,记录患者并发症发生情况.结果 患者术后冠状面主弯Cobb角、矢状面后凸Cobb角较术前明显改善,差异具有统计学意义(P<0.05),术后C7PL-CSVL、SVA较术前明显改善,差异具有统计学意义(P<0.05);患者术后Barthel指数评分高于术前,VAS评分低于术前,较术前明显改善,两组比较,差异具有统计学意义(P<0.05);2例患者术后出现下肢感觉功能减退,1例患者出现胸腔积液.结论 后路全椎体截骨矫形治疗重度脊柱畸形患者具有较好的矫形效果,但同时需要注意减少神经损伤等并发症的发生.

[目的]探讨纳米羟基磷灰石椎间融合器与钛钢板治疗颈椎间盘突出症的临床效果.[方法]选择2013年6月～2015年1月中日友好医院脊柱外科采用颈椎前路椎间盘切除减压并纳米羟基磷灰石椎间融合器与钛钢板治疗的颈椎间盘突出症患者47例,单节段11例,双节段26例,三节段10例;其中脊髓型颈椎病21例,神经根型颈椎病26例.[结果] 47例患者手术均顺利完成,无术后相关并发症发生,所有患者均获随访,时间3～18个月,平均10个月,术后末次JOA、NDI评分较术前均明显提高[(9.8±2.3)vs.(12.7±2.5);(23.1±5.7) vs.(32.5±6.1)],差异有统计学意义(P＜0.05);所有患者均获骨性融合,平均融合时间4个月,未出现融合器移位及下沉等情况.椎体间隙高度[(7.47±1.02) mm vs.(5.19±0.88) mm,P＜0.05]、颈椎生理曲度[(7.04±1.04) mmvs.(3.51±2.01) mm,P＜0.05]较术前明显恢复,差异有统计学意义(P＜0.05).[结论]纳米羟基磷灰石椎间融合器与钛钢板治疗颈椎间盘突出症,手术创伤不大,融合率高,能有效恢复椎体间隙高度及颈椎生理曲度,改善神经功能,术后效果良好.

Objective To investigate the cytotoxicity of cobalt (Co2+) and chromium (Cr3+) ions on mice osteoblast (MC3T3-E1) and the effects on the secretion of collagen-I from osteoblast under the stimulation of Co2+and Cr3+ions. Methods The osteoblast was cultured in vitro. The cell vitality was assured by MTT test. The ELISA and RT-PCR methods were applied to detect the col-lagen-I on gene and protein levels at 24 and 48 hours after co-culture respectively. Results Compared to the control,MTT test demonstrated that Co2+and Cr3+ions can obviously decrease the cell viability of osteoblast. When the osteoblasts were exposed to Co2+and Cr3+ions for 24 and 48 hours,the releasion of collagen-I decreased by 45.3% and 49.2% as compared with the control (P<0.05);the expression of collagen-I mRNA decreased by 26.8% at 24h,and 32.6% at 48h as compared with the group A (P<0. 05). Conclusion Co2+and Cr3+ions can inhibit the expression and release of collagen-I from osteoblast,and may have a cytotoxic effect on osteoblasts.

Objective To investigate the feasibility of establishing a 3D printed navigational template for cervicalpedicle screw placement,and to evaluate the accuracy of screw insertion.Methods From July 2013 to April 2015,data of 39 cases who had undergone pedicle screw placement assisted by 3D printed navigational template were retrospectively analyzed.There were 27 males and 12 females with an average age of 51.3 (range,39-58) years old.The pathogenesis included atlantoaxial dislocation in 17 cases,cervical metastases in 8 cases,and cervical spondylosis in 14 cases.The preoperative visual analogue scale (VAS) was 7.21±3.47,and the preoperative spinal function score of Japanes Orthopaedic Association (JOA) was 10.53±2.35.All the 39 patients had undergone CT scanning before operation.After the original data was imported into Mimics 17.0 software,the 3D models of cervicalvertebrae were reconstructed.The best trajectory of pedicle screw was extracted by UGS 12.0 Imageware software according to the reverse engineering principle.According to the lamina anatomic trait,a virtual navigational template with guiding rod and hole was established.The navigational template was manufactured by 3D printing.During the operation,the navigational template was used to assist with the placement of pedicle screw.The preoperative and postoperative VAS and JOA score were compared.The accuracy of pedicle screw placement was confirmed by postoperative CT scanning.Results All the patients had been through the operations successfully.The average operation time of the patients with atlantoaxial dislocation,cervical metastases,and cervical spondylosis were 182±43 min,217±62 min,and 235±54 min respectively,with an average blood loss of 436±287 ml,573±291 ml,and 384±226 ml respectively.The postoperative VAS of neck pain significantly decreased to 2.91±1.24,and the postoperative JOA score was significantly increased to 14.65±2.72.304 pedicle screws were inserted successfully,including 34 in C1,50 in C2,220 in C3-7.According to the Kawaguchi's standard,there were 287 screws in grade 0 (94.4％),15 in grade 1 (4.9％),and 2 in grade 2 (0.7％).Preoperative pedicle screw transverse angle of C1,C2,and C3-7 were 8.6°±2.3°,31.7°±8.6°,and 41.2°±9.6° respectively,and postoperative transverse angle were 9.1°± 3.5°,32.4°±7.7°,and 40.6°±9.3° respectively.Preoperative pedicle screw sagittal angle of C1,C2,and C3-7 were 9.2°± 1.7°,23.5°±4.8°, and-1.2°±2.2° respectively,and postoperative sagittal angle were 9.6°±2.1 °,22.7°±5.3°,and-1.4°±2.5° respectively.There were no significant differences between pre-and postoperative pedicle screw angles.Conclusion With the assistance of 3D printed navigational template,surgeons could change screw direction on the basis of template,clean off less soft tissues,and acquire high accuracy of cervical pedicle screw placement.

[目的]分析评估寰枢椎脱位前后路联合手术经口咽前路松解过程中,利用撬拨侧块测试后伸柔韧性确定寰枢关节松解程度的有效性和安全性.[方法]自2009年1月～ 2014年6月,回顾性分析采用经口咽前路松解、后路复位减压、寰枢椎或枕颈固定融合术治疗的寰枢椎脱位患者23例,男14例,女9例;年龄18～ 65岁,平均39.9岁.经口咽前路松解过程中,均按解剖层次逐步切除瘢痕、关节囊、韧带或植骨块等阻碍复位的组织,使寰枢侧块关节间隙在撬拨下获得3～5 mm的松动后,后路一期复位、固定、融合.术后根据X线片、CT评估复位及融合状态,JOA评分评估神经功能恢复情况.[结果]所有患者均顺利完成手术,手术时间180～350 min,平均260min;失血量400～1 100ml,平均700 ml.术中未发生椎动脉、神经和脊髓等损伤,术后无咽壁及椎管内感染发生.19例(82.6％)获得完全复位,4例(17.4％)不完全复位.脑干脊髓角恢复至平均143.5°,其中21例达到正常,2例小于正常.平均随访时间18个月(6～ 45个月),随访期间未见内固定松动表现,植骨均获得骨性融合;临床症状有所改善,JOA评分从术前平均7.8分提高到术后平均12.9分(P＜0.05).[结论]在经口咽前路松解过程中,侧块撬拨测试后伸柔韧性提供了简便可行的松解程度测试方式,活动度达到3～5 mm视为松解充分,成为前后路联合手术治疗严重寰枢椎脱位手术操作中的辅助技术.

Objective To investigate the effects on the secretion of collagen I from osteoblast and the ALP because of the stimulation of Co2+and Cr3+ions on mice osteoblast (MC3T3E1). Methods Culture the osteoblast in vitri. the ELISA and RT-PCR methods were applied to detect the ALP and collagen I on gene and proteins levels at 24 and 48 hours after co-cultured respec-tively. Result Compared to the control,Co2+and Cr3+ions can obviously decrease the ALP viability of osteoblast. When osteoblast were exposed to Co2+and Cr3+ions for 24 and 48 hours,the releasion of collagen-I have been decreased by 45.3% and 49.2% as compared with the control (P<0.05);the expression of collagen-I mRNA decreased by 26.8% at 24h,and 32.6% at 48h as com-pared with the control group (P<0.05). Conclusion Co2+and Cr3+ions restrain the ALP and the releasion of collagen-I from os-teoblast.

目的 探讨锁定钢板内固定结合自体植骨治疗老年桡骨远端骨质疏松性骨折的效果.方法 选择本院2009年3月～2012年8月收治的老年桡骨远端骨质疏松性骨折患者34例,均采用锁定钢板结合植骨治疗,采用掌侧入路,术中不显露背侧组织,骨缺损严重者植入自体骨.结果 32例患者术后均获得随访,随访时间6～13个月,平均9个月.骨折愈合时间平均10.5周.所有病例均无感染、骨不连、钢板松动、腕管综合征、正中神经炎等并发症.按照Dienst功能评分判定疗效,优24例,良5例,可3例,优良率为90.63％.结论 切开复位锁定钢板内固定结合植骨治疗老年骨质疏松性桡骨远端骨折具有固定可靠、退钉率低、利于早期功能锻炼、愈合快等优点,特别适用于老年骨质疏松患者.

10.3969/j.issn.2095-4344.2013.26.007

目的探讨胫骨近端骨折合并腘动脉损伤早期的诊断与治疗。方法对23例胫骨近端骨折合并腘动脉损伤患者骨折复位后采用钢板螺钉内固定,血管行断端直接吻合或大隐静脉逆转吻合术,神经损伤行神经松解。结果本组血管吻合后均持续畅通,创面在术后4周均愈合。骨折愈合时间6～9个月,平均7个月。随访1～2年,患肢功能恢复均满意。结论胫骨近端骨折合并腘动脉损伤早期正确诊断与尽快恢复肢体的血液循环对挽救肢体至关重要。

目的探讨肱骨近端锁定钢板治疗肱骨近端骨折的疗效评价。方法应用AO锁定钢板治疗肱骨近端骨折76例,其中男41例,女35例。根据Neer分型,其中Ⅱ型骨折28例,Ⅲ型骨折32例,Ⅳ型骨折16例。结果 76例获随访,骨折均愈合。根据Neer肩关节功能评分标准评定:优56例,良14例,可6例。优良率92.1%。结论肱骨近端锁定钢板治疗肱骨近端骨折固定可靠,并发症少。

目的评价抗骨质疏松药物联合双头加压螺钉治疗股骨颈骨折的作用。方法对35例老年骨质疏松行股骨颈骨折患者随机采用双头加压螺钉内固定术手术治疗(对照组16例)或双头加压螺钉配合鲑鱼降钙素、钙尔奇D片治疗(治疗组19例)。用X线检查比较两组患者术后骨折愈合时间,骨密度检测仪检测L2-4椎体术前及术后3个月骨密度变化。结果骨折愈合时间:治疗组(14±2.11)周,对照组(16±1.71)周,差异有统计学意义(P<0.05);治疗3个月后,治疗组L2-4椎体骨密度比术前有所下降(P>0.05),差异无统计学意义;而对照组则明显下降(P<0.05)。结论双头加压螺钉联合药物治疗骨质疏松性股骨颈骨折能有效促进骨痂生长,加速骨折的愈合。