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Meta-Analysis
. 2021 Apr 2;100(13):e25215.
doi: 10.1097/MD.0000000000025215.

Clinical efficacy of zoledronic acid combined with percutaneous kyphoplasty in the prevention and treatment of osteoporotic vertebral compression fracture: A systematic review and meta-analysis

Kaiming Li  1 , Hao Gong  2 , Rui Xie  1 , Jinyu Gu  1 , Shangquan Wang  1 , Chengyu Lin  1 , Jing Yin  1 , Xiaozhou Hou  1 , Qing Zhang  1 , Linghui Li  1 , Yanke Hao  3
Affiliations
Meta-Analysis

Clinical efficacy of zoledronic acid combined with percutaneous kyphoplasty in the prevention and treatment of osteoporotic vertebral compression fracture: A systematic review and meta-analysis

Kaiming Li et al. Medicine (Baltimore). .

Abstract

Objective:: The aim of this study is to investigate the clinical efficacy of zoledronic acid (ZOL) in the treatment and prevention of osteoporotic vertebral compression fractures (OVCF) after percutaneous kyphoplasty (PKP) for elderly patients.

Methods:: The PubMed, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang, VIP, and Embase were investigated through June 2020. All randomized controlled trials (RCT) involving ZOL injections for OVCF were enrolled. Outcome indicators included the bone mineral density (BMD), Visual Analog Scale (VAS), recompression vertebral fracture (RVF), Oswestry Disability Index (ODI), and bone metabolism (Procollagen type I N-terminal propeptide [PINP] and βcross-linked C-telopeptide of type I collagen [β-CTX]), bone cement leakage. Review Manager 5.3 was used to analyze these indicators.

Results:: In this study,

  1. (1)

    Eight studies had met the eligibility criteria, a total of 578 participants were involved (285 and 293 in the experimental (ZOL) group and control [no ZOL] group, respectively).

  2. (2)

    The BMD scores of patients with OVCF in the experimental group were significantly higher than that in the control group (P < .05).

The VAS scores were significantly different between the 2 groups at the 6, 12 months follow-up (P < .05). After PKP operation, ZOL injections reduced the rate of RVF (P < .05). In the comparison of ODI scores, the experimental group improved compared with the control group (P < .05). Respectively, the bone metabolism of patients with OVCF after ZOL was better than that of patients in control group (P < .05).

Conclusion:: Zoledronic acid had a significant effect on the treatment and prevention of OVCF in elderly osteoporotic patients after PKP. Due to the limited quality and data, more high-quality studies are needed to confirm the results of this meta-analysis.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Flow diagram of study selection.
Figure 2
Figure 2
Risk of bias assessment.
Figure 3
Figure 3
Risk of bias summary.
Figure 4
Figure 4
Forest plot and meta-analysis of BMD scores (6 and 12 mo).
Figure 5
Figure 5
Forest plot and meta-analysis of VAS scores (1, 6, 12 mo).
Figure 6
Figure 6
Forest plot and meta-analysis of RVF scores.
Figure 7
Figure 7
Forest plot and meta-analysis of ODI scores (12 mo).
Figure 8
Figure 8
Forest plot and meta-analysis of PINP scores.
Figure 9
Figure 9
Forest plot and meta-analysis of β-CTX scores.
Figure 10
Figure 10
Forest plot and meta-analysis of bone cement leakage scores.
See this image and copyright information in PMC

References

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