Optimization of Bone Regeneration in Patients with Osteoporotic Compression of Fractures of Vertebral Bodies of Thoracic and Lumbar Localization

The purpose of the article is to identify the main factors that determine the development of disorders in compression fractures of vertebral bodies of thoracic and lumbar localization on the background of postmenopausal and senile osteoporosis. This study was initiated 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 analyzed literature sources. Materials and Methods. Depending on the used treatment method, patients were divided into 3 groups: in group 1 (control group) there 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 on 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. Results and Discussion. Based on the obtained results of the study, we developed an algorithm for surgical treatment of patients with pathological vertebral fractures on 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. 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. Conclusions. 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.