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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
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