Clinic effects of bone-filling mesh bag and percutaneous vertebroplasty combined with postop-erative zoledronic acid in elderly patients with osteoporotic vertebral fractures
Objective To explore the clinical effect of bone-filling mesh bag and percutaneous vertebro-plasty(PVP)combined with postoperative administration of zoledronic acid in elderly patients with osteoporotic ver-tebral fractures(OVFs).Methods A retrospective analysis was conducted on 98 elderly patients with OVFs ad-mitted to the Spinal Surgery of Chifeng Municipal Hospital from Jan.2022 to Dec.2022.All patients received PVP based on bone-filling mesh bag(fully expanding the intervertebral space in all directions and inserting bone-filling mesh bags and bone cement for vertebral reduction)and osteoporosis treatment.Patients were divided into control group with conventional anti-osteoporosis drugs(45 cases,21 males and 24 females aged 60-78 years,mean 69.9 years)and observation group with additional intravenous infusion of the zoledronic acid once at 3 months after sur-gery(5 mg with the infusion time ≥ 15 min;49 cases,19 males and 30 females aged 60-81 years,mean 70.2 years).Both groups were continuously followed up for 12 months.The VAS,Oswestry dysfunction index(ODI),vertebral anatomy,and bone density before and 12 months after surgery were compared between the two groups,as well as the recurrence rate of OVFs and incidence of adverse drug reactions.Results Comparison between two groups revealed no statistically significant difference in gender,age,body mass index,disease duration,or lesion loca-tion(all P>0.05),as well as preoperative VAS,ODI,Cobb angle,anterior edge height of the injured vertebrae,T values by bone density of the hip and L1-4(all P>0.05).At 12 months after surgery,the observation group revealed much lower VAS(0.8±0.2 vs.1.2±0.3)and ODI(23.34%±3.45%vs.26.65%±4.12%,both P<0.05),simi-lar Cobb angle(10.54°±2.84° vs.10.99°±2.36°)and anterior edge height of the injured vertebra(mm,24.24±3.11 vs.23.23±2.96,both P>0.05),and much higher bone density T values at the hip(-3.05±0.49 vs.-3.44±0.53)and the L1-4levels(-1.92±0.28 vs.-2.54±0.47,both P<0.05).During the follow-up period,the recurrence rate of OVFs in the observation group was 2.04%,similar to 4.44%in the control group(P>0.05).Neither group reported serious adverse reactions.The incidence of adverse reactions in the observation group was 30.61%,much higher than 8.89%in the control group(P<0.05).Conclusion After PVP treatment based on bone-filling mesh bags in elderly patients with OVFs,the combined use of conventional anti-osteoporosis drugs and zoledronic acid can reduce pain,decrease ODI,improve the anatomical structure of the injury vertebrae,and enhance the bone density levels,but may increase the incidence of adverse reactions.
Spine fracturesOsteoporosisPercutaneous vertebroplasty with bone-filling mesh bagZole-dronic acidElderly