Skip to main content

Zoledronic acid combined with percutaneous kyphoplasty in the treatment of osteoporotic compression fracture in a single T12 or L1 vertebral body in postmenopausal women

Abstract

Summary

We performed a 1-year prospective study to see whether zoledronic acid infusion combined with percutaneous kyphoplasty could provide more benefits in the treatment of T12 or L1 osteoporotic vertebral compression fracture (OVCF).

Introduction

To investigate and analyze the clinical effects of zoledronic acid (ZOL) in combination with percutaneous kyphoplasty (PKP) in the treatment of OVCF in postmenopausal women.

Methods

Included in this study were 101 postmenopausal women patients with T12 or L1 OVCF who received PKP in our hospital between August 2015 and July 2017. They were randomly assigned to a zoledronic acid (ZOL) group (n = 50) or a control group (n = 51). Patients in ZOL group were treated preoperatively with IV infusion of 5 mg ZOL in combination with 0.25μg/d calcitriol and D3 600 mg/d calcium carbonate for a year. Patients in the control group were treated with the same dose of calcitriol and calcium carbonate D3 without ZOL.

Results

There was no statistically significant difference in age, height, weight, body mass index (BMI), menopause age, and the fractured vertebral body between the two groups. At 6 and 12 months after treatment, bone mineral density (BMD) in ZOL group was higher than that in the control group (p < 0.01); bone markers (NMID, P1NP, and β-CTX) and the VAS score in ZOL group were significantly lower than those in the control group. No new fracture occurred in ZOL group. The incidence of recompression vertebral fracture (RVF) in the control group was 11.7%, while no RVF was detected in any patient in ZOL group. Mild adverse reactions in ZOL group were significantly higher than those in the control group, but all of them were relieved after symptomatic treatment.

Conclusions

ZOL IV infusion in combination with PKP is beneficial for the treatment of T12 or L1 OVCF.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2
Fig. 3

References

  1. Cauley JA, Chalhoub D, Kassem AM, Fuleihan Gel H (2014) Geographic and ethnic disparities in osteoporotic fractures. Nat Rev Endocrinol 10(6):338–351

    Article  PubMed  Google Scholar 

  2. Kanis JA, Adachi JD, Cooper C, Clark P, Cummings SR, Diaz-Curiel M, Harvey N, Hiligsmann M, Papaioannou A, Pierroz DD et al (2013) Standardising the descriptive epidemiology of osteoporosis: recommendations from the Epidemiology and Quality of Life Working Group of IOF. Osteoporos Int 24(11):2763–2764

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Ballane G, Cauley JA, Luckey MM, El-Hajj Fuleihan G (2017) Worldwide prevalence and incidence of osteoporotic vertebral fractures. Osteoporos Int 28(5):1531–1542

    Article  CAS  PubMed  Google Scholar 

  4. Belhassen M, Confavreux CB, Cortet B, Lamezec L, Ginoux M, Van Ganse E (2017) Anti-osteoporotic treatments in France: initiation, persistence and switches over 6 years of follow-up. Osteoporos Int 28(3):853–862

    Article  CAS  PubMed  Google Scholar 

  5. Viswanathan M, Reddy S, Berkman N, Cullen K, Middleton JC, Nicholson WK, Kahwati LC (2018) Screening to prevent osteoporotic fractures: updated evidence report and systematic review for the US Preventive Services Task Force. JAMA 319(24):2532–2551

    Article  PubMed  Google Scholar 

  6. Garfin SR, Yuan HA, Reiley MA, Kaur U, Chakrabarti SS, Gambhir IS (2001) New technologies in spine: kyphoplasty and vertebroplasty for the treatment of painful osteoporotic compression fractures. Spine 26(14):1511–1515

    Article  CAS  PubMed  Google Scholar 

  7. Dhillon S (2016) Zoledronic acid (Reclast((R)), Aclasta((R))): a review in osteoporosis. Drugs 76(17):1683–1697

    Article  CAS  Google Scholar 

  8. Maricic M (2010) The role of zoledronic acid in the management of osteoporosis. Clin Rheumatol 29(10):1079–1084

    Article  PubMed  Google Scholar 

  9. Looker AC, Bauer DC, Chesnut CH 3rd, Gundberg CM, Hochberg MC, Klee G, Kleerekoper M, Watts NB, Bell NH (2000) Clinical use of biochemical markers of bone remodeling: current status and future directions. Osteoporos Int 11(6):467–480

    Article  CAS  PubMed  Google Scholar 

  10. Lange A, Kasperk C, Alvares L, Sauermann S, Braun S (2014) Survival and cost comparison of kyphoplasty and percutaneous vertebroplasty using German claims data. Spine 39(4):318–326

    Article  PubMed  Google Scholar 

  11. Safer U, Safer VB, Demir SO, Yanikoglu I (2016) Effects of bisphosphonates and calcium plus vitamin-D supplements on cognitive function in postmenopausal osteoporosis section sign. Endocr Metab Immune Disord Drug Targets 16(1):56–60

    Article  CAS  PubMed  Google Scholar 

  12. Hsieh PC (2016) Effectiveness and safety of zoledronic acid in the treatment of osteoporosis. Orthopedics 39(2):e263–e270

    Article  PubMed  Google Scholar 

  13. Liang BC, Shi ZY, Wang B, Wu P, Kong LC, Yao JL, Li CW, Shi XL (2017) Intravenous zoledronic acid 5 mg on bone turnover markers and bone mineral density in East China subjects with newly diagnosed osteoporosis: a 24-month clinical study. Orthop Surg 9(1):103–109

    Article  PubMed  Google Scholar 

  14. Jeon OC, Seo DH, Kim HS, Byun Y, Park JW (2016) Oral delivery of zoledronic acid by non-covalent conjugation with lysine-deoxycholic acid: in vitro characterization and in vivo anti-osteoporotic efficacy in ovariectomized rats. Eur J Pharm Sci 82:1–10

    Article  CAS  PubMed  Google Scholar 

  15. Bell KJ, Hayen A, Glasziou P, Irwig L, Eastell R, Harrison SL, Black DM, Bauer DC (2016) Potential usefulness of BMD and bone turnover monitoring of zoledronic acid therapy among women with osteoporosis: secondary analysis of randomized controlled trial data. J Bone Miner Res 31(9):1767–1773

    Article  CAS  PubMed  Google Scholar 

  16. Kim BS, Yang SS, Kim CS, Lee J (2018) Zoledronate suppresses VEGFinduced capillary tube formation and inhibits expression of interferoninduced transmembrane protein1 in human umbilical vein endothelial cells. Int J Mol Med 41(5):2879–2884

    CAS  PubMed  Google Scholar 

  17. Hagino H: [Evidence for positive effects of long-term bisphosphonate administration.]. Clin Calcium 2017, 27(2):203–211

  18. Shi C, Zhang M, Cheng AY, Huang ZF: Percutaneous kyphoplasty combined with zoledronic acid infusion in the treatment of osteoporotic thoracolumbar fractures in the elderly. Clin Interv Aging 2018, 13:853–861

  19. Lewiecki EM (2017) Treatment of low bone density or osteoporosis to prevent fractures in men and women. Ann Intern Med 167(12):902

    Article  PubMed  Google Scholar 

  20. Zuo XH, Zhu XP, Bao HG, Xu CJ, Chen H, Gao XZ, Zhang QX (2018) Network meta-analysis of percutaneous vertebroplasty, percutaneous kyphoplasty, nerve block, and control treatment for nonsurgery options of acute subacute and chronic osteoporotic vertebral compression fractures (OVCFs) in short-term and long-term effects. Medicine 97(29):e11544

    Article  PubMed  PubMed Central  Google Scholar 

  21. Dempster DW, Roschger P, Misof BM, Zhou H, Paschalis EP, Alam J, Ruff VA, Klaushofer K, Taylor KA (2016) Differential effects of teriparatide and zoledronic acid on bone mineralization density distribution at 6 and 24 months in the SHOTZ study. Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research 31(8):1527–1535

    Article  CAS  Google Scholar 

  22. Ding Y, Zeng JC, Yin F, Zhang CL, Zhang Y, Li SX, Liu X, Zhang C, Xue QY, Lin H et al (2017) Multicenter study on observation of acute-phase responses after infusion of zoledronic acid 5 mg in Chinese women with postmenopausal osteoporosis. Orthop Surg 9(3):284–289

    Article  PubMed  Google Scholar 

  23. Popp AW, Senn R, Curkovic I, Senn C, Buffat H, Popp PF, Lippuner K (2017) Factors associated with acute-phase response of bisphosphonate-naive or pretreated women with osteoporosis receiving an intravenous first dose of zoledronate or ibandronate. Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis\ Foundation of the USA 28(6):1995–2002

    Article  CAS  Google Scholar 

  24. Crotti C, Watts NB, De Santis M, Ceribelli A, Fabbriciani G, Cavaciocchi F, Marasini B, Selmi C, Massarotti M (2018) Acute phase reactions after zoledronic acid infusion: protective role of 25-hydroxyvitamin D and previous oral bisphosphonate therapy. Endocr Pract 24(5):405–410

  25. Wang H, Hu ZH, Chen L, Pan Y (2016) Influence of history of oral bisphosphonates on the incidence rate of fever after intravenous injection of zoledronic acid in patients with osteoporosis. Beijing Da Xue Xue Bao Yi Xue Ban 48(4):680–682

    PubMed  Google Scholar 

  26. Tian Y, Wang R, Liu L, Ma C, Lu Q, Yin F (2016) Acute bilateral uveitis and right macular edema induced by a single infusion of zoledronic acid for the treatment of postmenopausal osteoporosis as a substitution for oral alendronate: a case report. BMC Musculoskelet Disord 17:72

    Article  PubMed  PubMed Central  Google Scholar 

  27. Kulkarni P, Cushman T, Donthireddy V, Rao S (2016) Spontaneously recovered severe thrombocytopaenia following zoledronic acid infusion for osteoporosis. BMJ Case Rep 2016

  28. Kaur U, Chakrabarti SS, Gambhir IS: Zoledronate induced hypocalcemia and hypophosphatemia in osteoporosis: a cause of concern. Curr Drug Saf 2016, 11(3):267–269

  29. Aktas I, Nazikoglu C, Kepez A, Ozkan FU, Kaysin MY, Akpinar P, Dogan Z, Ileri C, Saymaz S, Erdogan O (2016) Effect of intravenous zoledronic acid infusion on electrocardiographic parameters in patients with osteoporosis. Osteoporos Int 27(12):3543–3547

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding authors

Correspondence to T. Zhang or D. Zhao.

Ethics declarations

Conflicts of interest

None.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Zhang, J., Zhang, T., Xu, X. et al. Zoledronic acid combined with percutaneous kyphoplasty in the treatment of osteoporotic compression fracture in a single T12 or L1 vertebral body in postmenopausal women. Osteoporos Int 30, 1475–1480 (2019). https://doi.org/10.1007/s00198-019-04896-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00198-019-04896-w

Keywords

  • Osteoporosis
  • Osteoporotic vertebral compression fracture
  • Percutaneous kyphoplasty
  • Zoledronic acid