日本語フィールド
著者：*小林 孝巨, 森本 忠嗣, 東藤 貢, 前田 和政, 吉原 智仁, 馬渡 正明題名：症例報告 テリパラチド連日製剤からロモソズマブへの切り換え後に腰椎骨密度と第一腰椎椎体の骨強度が改善した1例発表情報：Journal of Spine Research 巻: 12 号: 12 ページ: 1396-1400キーワード：テリパラチド, ロモソズマブ, 有限要素法, 腰椎概要：はじめに：今回我々は，テリパラチド連日製剤からロモソズマブへの切り換え後，腰椎骨密度および第一腰椎椎体の骨強度が増加した一例を報告する．
症例：症例は66歳女性である．腰痛と左下肢の痺れを自覚し近医を受診し，腰椎変性側弯（Cobb角24度），腰部脊柱管狭窄症と診断され当科へ紹介された．除圧術/矯正固定術前に骨粗鬆症治療を行う方針とした．原発性骨粗鬆症に対して，2017年8月から2019年3月迄テリパラチド連日製剤，2019年4月から2019年11月迄ロモソズマブを投与した．後顧的に初診時，テリパラチド連日製剤投与20ヶ月時，ロモソズマブ投与後8ヶ月時の腰椎CTデータを用いた体積平均の腰椎骨密度と有限要素解析による第一腰椎椎体の骨強度の検討を行った．骨強度は第一腰椎椎体の圧壊要素が1以上になる時の荷重値を調査した．初診時，テリパラチド連日製剤投与20ヶ月時，ロモソズマブ投与後8ヶ月時の腰椎骨密度の平均値は各々，643 mg/cm3，685 mg/cm3，742 mg/cm3，第一腰椎椎体の骨強度は各々，1,412 N，2,825 N，3,390 Nであった．
結語：テリパラチド連日製剤からロモソズマブへの切り換え後，更に腰椎骨密度と第一腰椎椎体の骨強度が増加した．抄録：英語フィールド
Author：*Takaomi Kobayashi, Tadatsugu Morimoto, Mitsugu Todo, Kazumasa Maeda, Tomohito Yoshihara, Masaaki MawatariTitle：Case Report A Case in Which the Bone Mineral Density and Bone Strength of the First Lumbar Vertebral Body Increased Due to Switching from Teriparatide Formulation for Daily Use to RomosozumabAnnouncement information:Journal of Spine Research Vol: 12 Issue: 12 Page: 1396-1400Keyword：Teriparatide, Romosozumab, Finite element method, Lumbar vertebraAn abstract：Introduction: We report a case in which the bone mineral density and bone strength in the first lumbar vertebral body increased after switching from daily use of teriparatide formulation to romosozumab.
Case report: A 66-year-old woman with symptoms of low back pain and numbness of the left lower limb consulted her doctor, who diagnosed her with lumbar degenerative scoliosis (Cobb angle, 24°) and lumbar spinal canal stenosis. She was referred to our department where the strategy was to treat osteoporosis before decompressive lumbar laminectomy/correction and fusion. For primary osteoporosis, daily teriparatide formulation was administered from August 2017 to March 2019, and then switched to romosozumab from April 2019 to November 2019. The lumbar bone mineral density (volume average) and bone strength of the first lumbar vertebral body were examined by finite element analysis using lumbar CT data obtained at the first visit, at 20 months after the administration of teriparatide, and at 8 months after the administration of romosozumab. The load values when the lumbar vertebral body crushing factor became one or more were investigated for bone strength. The average lumbar bone mineral density (volume average) at the first visit, 20 months after administration of teriparatide, and 8 months after administration of romosozumab was 643, 685 and 742 mg/cm3, respectively, while the body bone strength of the first lumbar vertebral was 1,412, 2,825 and 3,390 N, respectively.
Conclusions: We herein report a case in which the bone mineral density and bone strength of the first lumbar vertebral body increased after switching from daily use of a teriparatide formulation to romosozumab. Romosozumab is thought to have a strong effect on increasing the bone mineral density and bone strength at the lumbar vertebral body, even when administered as sequential therapy after daily use of teriparatide formulation.