Percutaneous kyphoplasty combined with zoledronic acid for the treatment of single segment osteoporotic lumbar vertebralcompression fractures / 中国综合临床

ABSTRACT

Objective To evaluate the clinical efficacy of percutaneous kyphoplasty combined with zoledronic acid for the treatment of single segment osteoporotic vertebral compression fractures (OVCF).Methods Clinical datas of 90 cases patients with postmenopausal suffered single segment vertebral compression fracture who were treated in Beijing ShiJingshan Hospital of Capital Medical University from March 2010 to March 2013 were retrospectively analyzed.The patienrs were randomly divided into three groups according to the different treatment methods,20 patients receivedbed rest treatment as conservative group,40 patients were undergone percutaneous kyphoplasty as operation group,30 patients were given percutaneous kyphoplasty combined with zoledronic acid as combination group.Visual analogue score (VAS) were recorded before treatment and 1 week,6 months after treatment,and lumbar vertebrae bone mineral density (BMD) was measured before treatment and 2 years after treatment.The subsequent fracture of the vertebrae was analyzed after 2 years of treatment.Results There were 4 patients were not followed up.Three patients in conservative group suffered complications,but no complications were observed in operation group and combination group.The VAS score of the combination group and operation group at 1 week after treatment was significantly different compared with conservative group((3.0± 1.4) points vs.(3.2± 1.2) points vs.(8.0± 1.1) points,P＜0.05).At the 6 months after treatment,there were no significant differences among the 3 groups on VAS score (P ＞0.05).Lumbar vertebrae BMD of combination group increased at 2 years after treatment,compared with conservative group and operation group the difference were significantly((-1.8±0.6) vs.(-3.1±0.5) vs.(-2.7±0.3),P ＜0.05).The incidence of the subsequent fracture of the vertebrae reduced of combination group,compared with conservative group and operation group the difference were significantly (3.3％ (1/30) vs.27.8％ (5/18)vs.21.1％ (8/38),P＜ 0.05).Conclusion Percutaneous kyphoplasty combined with zoledronic acid for the treatment of OVCF-patients with postmenopausal and single segment fracture is not only safe,effective,but also can obviously relive pain and reduce the risk of subsequent fracture of the vertebrae.