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Percutaneous kyphoplasty combined with zoledronic acid for the treatment of primary osteoporotic vertebral compression fracture: a prospective, multicenter study

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

To explore the therapeutic efficacy of percutaneous kyphoplasty (PKP) combined with zoledronic acid (ZOL) in postmenopausal women and adult men with osteoporotic vertebral compression fracture (OVCF).

Materials and methods

A total of 238 patients with OVCF were randomly assigned to the control or ZOL group: 119 patients were treated with only PKP (control group), and 119 were treated with ZOL infusion after PKP (ZOL group). Clinical, radiological and laboratory indices were evaluated at follow-up.

Results

The visual analog scale (VAS) score and Oswestry Disability Index (ODI) were significantly higher in both groups post-treatment than at baseline (all p < 0.01). The bone mineral density (BMD) of the proximal femoral neck and height of the injured vertebra were significantly increased after treatment compared with before treatment, and the Cobb angle of the injured vertebra was significantly decreased in both groups (all p < 0.01). However, the bone metabolism indices (type I procollagen amino-terminal peptide (PINP), beta type I collagen carboxy-terminal peptide (β-CTX), and osteocalcin in the N-terminal molecular fragment (NMID)) were significantly lower post-treatment than at baseline in only the ZOL group (all p < 0.01). The VAS score, ODI, BMD, PINP level, β-CTX level, NMID level, vertebral height and Cobb angle of the injured vertebra were significantly higher in the ZOL group than in the control group (all p < 0.01). There were no significant differences in the postoperative bone cement leakage rate between the two groups. At follow-up, new OVCFs were experienced by 16 patients in the control group and 2 patients in the ZOL group (p < 0.01).

Conclusion

The therapeutic efficacy of PKP combined with ZOL for primary OVCF is clinically beneficial and warrants further study.

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Data Availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Acknowledgements

The authors wish to thank all patients involved in the study as well as the investigators and research staff of the participating institutions.

Funding

This analysis was funded by the New Teachers Start-up Fund Project of Beijing University of Chinese Medicine (2019-JYB-XJSJJ042).

Author information

Author notes

  1. Kan Liu, Guanzhong Tan and Wei Sun are co-first authors.

Authors and Affiliations

  1. Department of Orthopedics, Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing, China

    Kan Liu & Dong Yu

  2. Department of Orthopedics, Nanning Hospital of Traditional Chinese Medicine, Naning, China

    Guanzhong Tan

  3. Department of Intensive Care Unit, Nanyuan Hospital, Beijing, China

    Wei Sun

  4. Department of Radiology, University Hospital Southampton NHS Foundation Trust, Southampton, UK

    Qiang Lu

  5. Department of Orthopedics, Beijing Tongren Hospital, Capital Medical University, Beijing, China

    Jiaguang Tang

Authors
  1. Kan Liu
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Corresponding authors

Correspondence to Jiaguang Tang or Dong Yu.

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The authors have declared no conflicts of interest for this article.

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All procedures performed in studies involving human participants were approved by the corresponding Institutional Review Board (IRB) and registered on the ChiCTR.org (ChiCTR2100054015) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Written informed consent was obtained from the patients or their parents. All authors read and approved the final manuscript.

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Liu, K., Tan, G., Sun, W. et al. Percutaneous kyphoplasty combined with zoledronic acid for the treatment of primary osteoporotic vertebral compression fracture: a prospective, multicenter study. Arch Orthop Trauma Surg 143, 3699–3706 (2023). https://doi.org/10.1007/s00402-022-04557-4

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