Comparative study of percutaneous kyphoplasty combined with zoledronic acid at different times in the treatment of osteoporotic vertebral compression fractures / 中国医师进修杂志

ABSTRACT

Objective:To compare the effect of percutaneous kyphoplasty (PKP) combined with zoledronic acid at different times in the treatment of osteoporotic vertebral compression fractures (OVCF).Methods:The clinical data of 110 patients with OVCF from January 2018 to June 2019 in the Hospital of Shunyi District Beijing were retrospectively analyzed. All patients were treated with PKP. Among them, 55 patients were given zoledronic acid on the second day after surgery (synchronization group), and 55 patients were given zoledronic acid 1 month after surgery (non-synchronization group). X-Ray examination was performed before and 1 year after surgery, and the vertebral recovery related indexes of compression fracture vertebral body were measured, including anterior border height of vertebral body, posterior border height of vertebral body, kyphotic angle and local Cobb angle; the degree of dysfunction was evaluated by Oswestry dysfunction index (ODI); the bone density of hip bone was detected; the serum alkaline phosphatase (ALP), osteocalcin and type Ⅰ collagen cross-linked C-terminal peptide (CTX-1) were detected. The patients were followed up for 1 year, and the recurrence of vertebral compression fractures was record.Results:There were no statistical differences in anterior border height of vertebral body, posterior border height of vertebral body, kyphotic angle and local Cobb angle before surgery and 1 year after surgery between 2 groups ( P>0.05). Compared with those before surgery, the anterior border height of vertebral body and posterior border height of vertebral body 1 year after surgery in 2 groups were significantly higher, the kyphotic angle and local Cobb angle were significantly lower, and there were statistical differences ( P<0.01). The ODI 1 year after surgery in synchronization group was significantly lower than that in non-synchronization group (11.30 ± 1.53) scores vs. (14.27 ± 1.78) scores, and there was statistical difference ( P<0.01). The bone density of hip bone 1 year after surgery in synchronization group was significantly higher than that in non-synchronization group, and there was statistical difference ( P<0.01). The serum ALP and CTX-1 1 year after surgery in synchronization group were significantly lower than those in non-synchronization group (74.93 ± 8.63) U/L vs. (78.77 ± 9.41) U/L and (0.24 ± 0.03) ng/L vs. (0.29 ± 0.03) ng/L, the osteocalcin was significantly higher than that in non-synchronization group (9.63 ± 1.14) ng/L vs. (7.97 ± 0.85) ng/L, and there were statistical differences ( P<0.01 or <0.05). All patients were followed up for 1 year, and no recurrence of vertebral compression fractures was found. Conclusions:The synchronization zoledronic acid after PKP has more advantages in improving the condition and bone metabolism in patients with OVCF.