| Objective:The purpose of this study was to observe the clinical effect of percutaneous kyphoplasty(PKP)combined with zoledronic acid in the treatment of osteoporotic vertebral compression fractures in postmenopausal women and its clinical curative effect and the effect on the bone mineral density of the patient,and to explore whether zoledronic acid can reduce the recurrence rate of compression fractures of vertebrae after percutaneous kyphosis.Methods:This study used a retrospective case-analysis method to retrospectively analyze post-menopausal women with vertebral compression fractures due to post-menopausal osteoporosis from 2014/01 to 2017/01 and treated with percutaneous kyphoplasty in our hospital.Exclude patients with initial PKP treatment in the external hospital,cancer disease,history of fracture trauma,follow-up for less than half a year or patients who were lost to follow-up,in last,a total of 226 patients with OVCFs were enrolled,of which 125 were in the experimental group and 101 in the control group.Patients treated with zoledronic acid after PKP were assigned to the experimental group.Patients who were not treated with zoledronic acid after PKP were assigned to the control group.All patients were treated with calcium and vitamin D as the basic treatment for osteoporosis.The patients enrolled in the routine outpatient clinic after PKP were performed.Oswestry dysfunction(ODI)score,visual analog back pain(VAS)score,diseased and adjacent vertebral body X-ray were examined before and after operation.The bone mineral T value trends and the reoccurrence rate of the vertebral compression fracture after PKP in the two groups were examined and the effects of the combined use of the bone density on the bone mineral density and the reappearance of the fracture of the vertebral body were evaluated.All grouped data were statistically processed using SPSS 16.0 software.Through clinical comparative analysis,the significance of combined with zoledronic acid after PKP treatment for bone mineral density recovery in postmenopausal osteoporosis patients was evaluated.Results:In the experimental group and the control group,the injured vertebrae showed normal distribution in the range of T5-L5 segment,and the thoracolumbar segment was the high incidence site of vertebral compression fracture.The VAS score of the experimental group was 8.65±0.81 before operation,3.16±0.84 3 days after operation and 2.59 ± 1.02 1 year after operation.The VAS score of the control group was 8.62±1.09 before operation,3.1110.87 three days after operation and 3.38 ± 1.21 one year after operation.The ODI score of the experimental group was 48.69 15.07 before operation,23.63 ±2.99 three days after operation and 20.08±3.40 one year after operation.The ODI score of the control group was 48.34±5.73 before operation,23.70±3.96 three days after operation and 24.18±5.50 one year after operation.The VAS and ODI scores of the two groups were significantly improved at 3 days and 12 months after PKP(P<0.05).The VAS and ODI scores of the experimental group were significantly lower than those of the control group at 12 months after PKP(P<0.05).The BMD of the lumbar spine(L2-L4)was-2.75±1.01 before operation and-2.06 ± 1.03 one year after operation,and that of the left femoral neck was-2.84±0.83 before operation and-2.31±0.78 one year after operation in the experimental group.The BMD of the lumbar spine(L2-L4)in the control group was-2.68±0.81 before operation and-2.42±1.04 one year after operation,while that of the left femoral neck was-2.81±0.74 before operation and-2.93±0.70 one year after operation.The bone mineral density of the experimental group was significantly improved compared with that of the preoperative group(P<0.05).One year later,the bone mineral density of the experimental group was significantly better than that of the control group(P<0.05).The recurrence rate of vertebral compression fracture in the experimental group was significantly lower than that in the control group within 24 months after operation(P<0.05).Conclusion:The clinical effect of zoledronic acid combined with zoledronic acid in the treatment of vertebral compression fracture in postmenopausal women with osteoporosis is remarkable,which can obviously relieve the long-term pain,and increase the bone mineral density.Meanwhile,the incidence of vertebral fracture in the experimental group is significantly decreased.Therefore,the combined use of zoledronic acid is an effective preventive measure to reduce the recurrent fracture of vertebral body in postmenopausal patients with osteoporosis after PKP. |
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