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

Authors Shi C, Zhang M, Cheng AY, Huang ZF

Received 20 July 2017

Accepted for publication 22 February 2018

Published 4 May 2018 Volume 2018:13 Pages 853—861

DOI https://doi.org/10.2147/CIA.S146871

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 3

Editor who approved publication: Dr Wu


Chen Shi,1,* Mi Zhang,2,* An-Yuan Cheng,1 Zi-Feng Huang1

1Department of Trauma Surgery, Wuhan No 1 Hospital, Wuhan, China; 2Department of Orthopedics, Wuhan No 5 Hospital, Wuhan, China

*These authors contributed equally to this work

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: zoledronic acid, percutaneous kyphoplasty, osteoporotic thoracolumbar fractures, elderly, clinical outcomes, osteoporosis

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