Application Of Zoledronic Acid In Osteoporotic Vertebral Compression Fracture After PKP Surgery

ObjectiveResearch and analysis of osteoporotic vertebral compression fractures(OVCF)after percutaneous kyphoplasty(PKP)after the application of zoledronic acid(ZOL),to explore the best treatment plan and clear security.MethodsThis study selected 105 female osteoporotic vertebral compression fracture patients who were treated in the Second Affiliated Hospital of Zhengzhou University from January 2016 to March 2018.Among them,35 patients received ZOL 100ml once a year,35 patients received PKP surgery,35 patients received PKP+ZOL,and all patients were followed up for 2 years.The visual analog pain scale(VAS)score,Oswestry Disability Index questionnaire(ODI)score,Bone Mineral Density(BMD)T score,the height of the compressed vertebral body,the kyphotic wedge angle,the incidence of re-fracture of adjacent vertebral bodies and related complications of the three groups of patients were compared before and after treatment.Results(1)The three groups of patients were classified according to age,body mass index(BMI),American Society of Anethesiologists(ASA),number of compressed vertebrae,BMD-T score before treatment,VAS score,ODI score,There was no.significant difference in the baseline data of the compressed vertebral anterior edge height,kyphosis wedge angle and other baseline data(P>0.05).(2)There was no significant change in BMD-T scores before and after treatment in the PKP group.The BMD-T scores at each time point after treatment in the ZOL group and the PKP+ZOL group were higher than before treatment and higher than those in the PKP group.The differences were statistically significant(P<0.05).After treatment,the VAS scores of the three groups were all lower than those before surgery,and the difference was statistically significant(P<0.05).The ODI score of patients in PKP group and PKP+ZOL group after treatment was lower than that before treatment and lower than that in ZOL group,the difference was statistically significant(P<0.05).The anterior height of the vertebral body and the kyphosis wedge angle of the patients in the PKP group and the PKP+ZOL group were better than those in the ZOL group after treatment,and the differences were statistically significant(P<0.05).During the follow-up,the recurrence rate of vertebral compression fractures in the PKP+ZOL group was lower than that in the PKP and ZOL groups,and there was a statistically significant difference between the PKP+ZOL group and the PKP group(P<0.05).(3)In all patients undergoing PKP surgery,the postoperative X-ray showed no serious bone cement leakage events,and no serious complications such as cardiac arrest,pulmonary embolism,bleeding,infection,etc.;in patients undergoing ZOL treatment There were different degrees of influenza-like symptoms in the acute phase,such as fever,fatigue,and general body pain.There was no statistically significant difference in the acute phase response between the two groups of patients ZOL and PKP+ZOL(P>0.05).During the follow-up period,no long-term adverse reactions of ZOL occurred in the patients in the group,such as the following jaw necrosis.There was no significant difference between the three groups when comparing other related complications(P>0.05).Conclusions(1)Simply applying PKP surgery can restore the height of the compressed vertebral front edge,correct the kyphosis of the vertebral body,reduce the pain caused by the fracture,and improve the quality of life,but it cannot increase the bone density and delay the process of osteoporosis.(2)ZOL alone can increase bone density and relieve pain to a certain extent,but it cannot improve the quality of life and does not reduce the incidence of vertebral re-fractures.(3)Zoledronic acid combined with PKP surgery can significantly relieve pain,improve the quality of life of patients after surgery,restore spinal stability,reduce the incidence of postoperative fractures,and do not increase the incidence of various adverse events.