Curative Effect Study On PKP Combined With Zoledronic Acid In The Treatment Of Thoracolumbar OVCF

Objective : To investigate the clinical effect on percutaneous kyphoplasty(PKP)combined with zoledronic acid in the treatment of thoracolumbar osteoporotic vertebral compression fracture(OVCF).Methods:42 patients with thoracolumbar OVCF who met the inclusion criteria began to take calcium carbonate D3 tablets and calcitriol capsules regularly after admission for six consecutive months.All patients were divided into drug group and routine group according to whether they agreed to use zoledronic acid after PKP,21 cases in each group.Zoledronic Acid Injection was performed on the third day after operation in the medication group,the conventional group was treated the same as that before operation.The differences of pain visual analogue score(VAS),Oswestry dysfunction index(ODI)and sagittal Cobb's angle between the two groups were compared before operation,3 days,1 month and 6 months after operation.The total hip bone mineral density of the left side of the two groups were compared before operation,1 months and 6months after operation respectively.The adverse drug reactions and the number of new cases of adjacent vertebral fractures in two groups were recorded within 6 months after operation.Results :There was no significant difference in VAS score,ODI and sagittal Cobb's angle between the two groups before operation and 3 days after operation(P >0.05).The VAS score,ODI and the sagittal Cobb's angle of spine in the drug group were significantly decreased in 1 month and 6 months follow-up Postoperatively(P < 0.05),and the reduction was significantly better than that in the conventional group(P < 0.05).There was significant difference in VAS score and ODI between 6 months postoperative and 1month postoperative in drug group(P < 0.01),but there was no significant difference in VAS score and ODI between 6 months postoperative and 1 month postoperative in routine group(P > 0.05).Three follow-up visits after surgery showed that the Cobb's angleincreased gradually in the routine group,the difference was statistically significant(P <0.01),while the postoperative Cobb's angle did not change significantly in the drug group(P > 0.05).There was no significant difference in preoperative bone mineral density(BMD)T value of left hip between the two groups(P > 0.05).The bone mineral density of the left hip joint of the two groups increased after 1 months and 6 months follow-up,and the BMD in drug group was significantly higher than that in routine group(P < 0.05).The BMD in routine group was not significantly higher than that preoperative at 1 month after operation(P > 0.05).BMD in 6 months postoperative was significantly higher than that before surgery(P < 0.01).Conclusion:PKP combined with zoledronic acid,calcium carbonate D3 tablets and calcitriol capsules is effective in the treatment of thoracolumbar OVCF,which can relieve pain,improve bone mineral density,improve quality of life and prevent adjacent vertebral fractures,and it is worthy of promotion.