PMC3534324_01
Radiographs of thoracic and lumbar spine.. Notes: Lateral views before treatment. Radiographs of thoracic and lumbar spine before treatment showed the existence of morphometric vertebral fractures at the 6th, 8th, and 10th thoracic vertebrae and the 2nd lumbar vertebra.. Abbreviation: T12, 12th thoracic spine.
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Radiographs of the thoracic and lumbar spine showed the existence of morphometric vertebral fractures (at the 6th, 8th, and 10th thoracic vertebrae and the 2nd lumbar vertebra, Figure 1).
Changes in lumbar spine BMD during the 11-year period of treatment.. Notes: Treatment with cyclical etidronate plus alfacalcidol was initiated. The lumbar spine BMD increased at one year after the start of etidronate plus alfacalcidol treatment but decreased at 2 years. Treatment was switched from etidronate plus alfacalcidol to alendronate plus alfacalcidol, and this treatment was continued for 9 years. The increase in lumbar spine BMD from baseline was 2.8% at one year, 2.1% at 2 years, 4.6% at 3 years, 4.6% at 4 years, 5.0% at 5 years, 5.0% at 6 years, 5.3% at 7 years, 5.9% at 8 years, 6.4% at 9 years, 6.2% at 10 years, and 6.4% at 11 years.. Abbreviations: BMD, bone mineral density; ETD, etidronate; ALN, alendronate.
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Figure 2 shows the longitudinal changes in lumbar spine BMD during the 11-year period of treatment.
Changes in biochemical markers during the 11-year period of treatment.. Notes: The patient was treated with cyclical etidronate plus alfacalcidol for 2 years and alendronate plus alfacalcidol for 9 years. The serum alkaline phosphatase level decreased at one and 2 years after the start of etidronate plus alfacalcidol treatment and was sustained thereafter for 9 years. The reduction in the serum alkaline phosphatase level was 16.2% at one year, 24.2% at 2 years, 23.7% at 3 years, 26.5% at 4 years, 26.7% at 5 years, 24.2% at 6 years, 20.6% at 7 years, 21.2% at 8 years, 21.7% at 9 years, 21.2% at 10 years, and 20.3% at 11 years. The serum calcium, phosphorus, and intact parathyroid hormone levels stayed within the normal ranges during the 11-year period of treatment. A: Calcium, B: Phosphorus, C: ALP, D: intact PTH.. Abbreviations: ALP, alkaline phosphatase; PTH, parathyroid hormone; ETD, etidronate; ALN, alendronate.
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Figure 3 shows the longitudinal changes in serum calcium, phosphorus, alkaline phosphatase, and intact parathyroid hormone levels during the 11-year period of treatment.
Radiographs of thoracic and lumbar spine.. Notes: Lateral views after 11 years of treatment. After 11 years of treatment, radiographs of the thoracic and lumbar spine revealed the existence of morphometric vertebral fractures (at the 5th, 6th, 8th, 9th, and 10th thoracic vertebrae and the 2nd lumbar vertebra), suggesting the occurrence of new morphometric vertebral fractures (at the 5th and 9th thoracic vertebrae).. Abbreviation: T12, 12th thoracic spine.
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Radiographs of the thoracic and lumbar spine revealed the existence of morphometric vertebral fractures (at the 5th, 6th, 8th, 9th, and 10th thoracic vertebrae and the 2nd lumbar vertebra) after 11 years of treatment (Figure 4), suggesting the occurrence of new morphometric vertebral fractures (at the 5th and 9th thoracic vertebrae).