Effectiveness Analysis of Percutaneous Kyphoplasty Combined with Zoledronic Acid in Treatment of Primary Osteoporotic Vertebral Compression Fractures

Objective: To investigate the therapeutic effectiveness of percutaneous kyphoplasty (PKP) combined with zoledronic acid in treatment of primary osteoporotic vertebral compression fractures. Study Design: A perspective cohort study was conducted at a single institution for patients, who received PKP operation due to primary osteoporotic vertebral compression fracture between January 2014 and January 2015. Setting: According to whether they received postoperative zoledronic acid or not, patients were divided into treatment or control groups, with 30 randomly-selected cases per group. Methods: The visual analogue scale (VAS), which was used to assess the degree of pain, and the bone mineral density, was analyzed at 1-, 6-, and 12-month follow-ups. Results: In general, patients experienced marked pain relief after surgery. No significant difference in pain relief was observed in the control group between the 6 and 12-month follow-up. In contrast, the VAS score of the treatment group at 12-month follow-up was significantly lower than that at 6-month (P value = 0.03). Moreover, it was also significantly lower than the VAS score in the control group at the 12-month follow-up (P value = 0.0018). The bone mineral density of patients from the treatment group increased significantly and progressively after the surgery (pre-operation versus 6-month follow-up: P value = 0.01; 6-month versus 12-month follow-up: P value < 0.001), and it was also remarkably higher than that of the control group at the 12-month follow-up (P value < 0.0001). Limitations: Patients were collected from a single hospital. The maximum postoperative follow-up time was 12 months. The sample size was relatively small. Thus, bias could occur in the selection of cases if they are not representative of the population. Conclusion: The combined treatment of zoledronic acid with PKP for primary osteoporotic vertebral compression fractures safely and effectively relieved low back pain, significantly increased bone density, and improved the quality of life. The clinical effectiveness is promising and worthy of further study.