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. 2018 May 4:13:853-861.
doi: 10.2147/CIA.S146871. eCollection 2018.

Percutaneous kyphoplasty combined with zoledronic acid infusion in the treatment of osteoporotic thoracolumbar fractures in the elderly

Chen Shi #  1 , Mi Zhang #  2 , An-Yuan Cheng  1 , Zi-Feng Huang  1
Affiliations

Percutaneous kyphoplasty combined with zoledronic acid infusion in the treatment of osteoporotic thoracolumbar fractures in the elderly

Chen Shi et al. Clin Interv Aging. .

Abstract

Objective: We studied the efficacy of zoledronic acid (ZOL) infusion on radiographic and clinical outcomes after percutaneous kyphoplasty (PKP) for elderly patients with osteoporotic thoracolumbar fractures (osteoporotic vertebral compression fractures [OVCFs]).

Materials and methods: We retrospectively analyzed 95 elderly patients (age >65 years) with OVCF. All patients were followed up for 2 years. Thirty-two patients were treated with only once-yearly 5 mg ZOL infusion (ZOL group), 34 patients with only PKP (PKP group) and 29 patients received ZOL infusion 3 days after PKP (PKP+ZOL group).

Results: There were no significant differences in the patients' age, gender, body mass index, lumbar spine bone mineral density T-scores, baseline of Visual Analog Scale scores and Oswestry Disability Index scores (P>0.05). The postoperative vertebral heights of patients with OVCF after PKP and PKP+ZOL were 23.70±3.03 and 24.30±3.13 mm, respectively, which were significantly higher than that of patients in ZOL group (P<0.05). The reduction in degrees of kyphotic deformity in the PKP and PKP+ZOL groups were corrected to 8.4° and 8.7°. The bone mineral density T-scores of patients with OVCF in the ZOL group and PKP+ZOL group were significantly higher than that in the PKP group (P<0.05). The Visual Analog Scale and the Oswestry Disability Index scores of the PKP+ZOL and PKP groups were significantly lower than those of the ZOL group (P<0.05). The incidence of recompression vertebral fracture (RVF) in the PKP group was 14.7%, but there was no patient with RVF in the PKP+ZOL group (P<0.05).

Conclusion: Once-yearly 5 mg ZOL infusion combined with PKP could provide beneficial effects in elderly osteoporotic patients with OVCF.

Keywords: clinical outcomes; elderly; osteoporosis; osteoporotic thoracolumbar fractures; percutaneous kyphoplasty; zoledronic acid.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Vertebral body height before and after PKP and/or ZOL infusion. Notes: Data are presented as mean±SD. *P<0.05 PKP group vs ZOL group; **P<0.05 PKP+ZOL group vs ZOL group; #P<0.05 PKP+ZOL group vs PKP group. Pre: before PKP and/or ZOL infusion; post: after PKP and/or ZOL infusion. Abbreviations: PKP, percutaneous kyphoplasty; ZOL, zoledronic acid.
Figure 2
Figure 2
Kyphotic wedge angle before and after PKP and/or ZOL infusion. Notes: Data are presented as mean±SD. *P<0.05 PKP group vs ZOL group; **P<0.05 PKP+ZOL group vs ZOL group; #P<0.05 PKP+ZOL group vs PKP group. Pre: before PKP and/or ZOL infusion; post: after PKP and/or ZOL infusion. Abbreviations: PKP, percutaneous kyphoplasty; ZOL, zoledronic acid.
Figure 3
Figure 3
A 71-year-old female patient with T11 OVCF who received the combination treatment of PKP and ZOL infusion. Notes: (A–C) The posteroanterior radiograph of thoracolumbar spine preoperatively, 1 year postoperatively and 2 years postoperatively. (D–F) The lateral radiograph thoracolumbar spine preoperatively, 1 year postoperatively and 2 years postoperatively. Abbreviations: OVCF, osteoporotic vertebral compression fracture; PKP, percutaneous kyphoplasty; ZOL, zoledronic acid.
Figure 4
Figure 4
BMD T-scores at lumbar spine before and after PKP and/or ZOL infusion. Notes: Data are presented as mean±SD. *P<0.05 ZOL group vs PKP group; **P<0.05 PKP+ZOL group vs PKP group; #P<0.05 compared with the baseline. Post: after PKP and/or ZOL infusion. Abbreviations: BMD, bone mineral density; PKP, percutaneous kyphoplasty; ZOL, zoledronic acid.
Figure 5
Figure 5
VAS before and after PKP and/or ZOL infusion. Notes: Data are presented as mean±SD. *P<0.05 PKP group vs ZOL group; **P<0.05 PKP+ZOL group vs ZOL group; #P<0.05 compared with the baseline. Pre: before PKP and/or ZOL infusion; post: after PKP and/or ZOL infusion. Abbreviations: PKP, percutaneous kyphoplasty; VAS, Visual Analog Scale; ZOL, zoledronic acid.
Figure 6
Figure 6
ODI before and after PKP and/or ZOL infusion. Notes: Data are presented as mean±SD. *P<0.05 PKP+ZOL group vs ZOL group; **P<0.05 PKP group vs ZOL group; #P<0.05 PKP+ZOL group vs PKP group. Pre: before PKP and/or ZOL infusion; post: after PKP and/or ZOL infusion. Abbreviations: ODI, Oswestry Disability Index; PKP, percutaneous kyphoplasty; ZOL, zoledronic acid.
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References

    1. Curtis EM, Moon RJ, Dennison EM, Harvey NC, Cooper C. Recent advances in the pathogenesis and treatment of osteoporosis. Clin Med. 2016;16(4):360–364. - PMC - PubMed
    1. Lin X, Xiong D, Peng YQ, et al. Epidemiology and management of osteoporosis in the People’s Republic of China: current perspectives. Clin Interv Aging. 2015;10:1017–1033. - PMC - PubMed
    1. Ballane G, Cauley JA, Luckey MM, El-Hajj Fuleihan G. Worldwide prevalence and incidence of osteoporotic vertebral fractures. Osteoporos Int. 2017;28(5):1531–1542. - PubMed
    1. Kung AW. Epidemiology and diagnostic approaches to vertebral fractures in Asia. J Bone Miner Metab. 2004;22(3):170–175. - PubMed
    1. Cauley JA, Chalhoub D, Kassem AM, Fuleihan Gel-H. Geographic and ethnic disparities in osteoporotic fractures. Nat Rev Endocrinol. 2014;10(6):338–351. - PubMed

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