Effect of PVP combined with zoledronic acid in the treatment of multi-vertebral osteoporotic compression fractures and the influence on lumbar function and re-fracture rate
Effect of PVP combined with zoledronic acid in the treatment of multi-vertebral osteoporotic compression fractures and the influence on lumbar function and re-fracture rate
Objective To investigate the effect of percutaneous vertebroplasty(PVP)combined with zoledronic acid in the treatment of multi-vertebral osteoporotic vertebral compression fractures(OVCF),and the influence on lumbar function and re-fracture rate.Methods A total of 136 patients with OVCF who were admitted to Air Force Hospital of Western Theater Command from August 2016 to August 2020 were re-viewed.According to treatment method,the patients were divided into control group(PVP combined with anti-osteoporosis drugs)and study group(zoledronic acid treatment on the basis of the treatments of control group),with 68 patients in each group.Clinical effects,lumbar function[Oswestry Dysfunction Index(ODI),Activity of Daily Living(ADL)score],bone density,serum biochemical indicators[blood calcium,blood phosphorus,serum bone gla protein,bone alkaline phosphatase(NBAP)]and occurrence of postoperative re-fracture were compared between the two groups.Results After treatment,the markedly effective rate in the study group was significantly higher than that in the control group,the difference was statistically significant(P＜0.05).After treatment,ODI scores decreased,and the ADL scores increased in the two groups,the ODI scores of study group were(51.76±5.69)pionts,which were significantly lower than those of the control group[(64.95±5.48)pionts],and the ADL scores were(87.19±7.41)pionts,which were significantly higher than those of the control group[(75.66±7.63)pionts]),the differences were statistically significant(P＜0.05).After treatment,bone mineral densities of lumbar spine L1～5 and femoral neck increased in the two groups,and the bone mineral densities of study group were(0.86±0.18),(0.88±0.15)g/cm2,which were significantly higher than those of the control group[(0.77±0.16),(0.74±0.17)g/cm2],the differences were statistically significant(P＜0.05).After treatment,the levels of blood calcium and bone alkaline phosphatase decreased,and the levels of blood phosphorus and bone gla protein increased in the two groups,bone gla protein in the study group was(10.34±1.45)ng/mL,which was higher than in the control group[(8.16±1.56)ng/mL],and serum NBAP level was(19.46±2.34)U/L,which was lower than that in the control group[(25.94±2.38)U/L],the differences were statistically significant(P＜0.05).During the follow-up period,The incidence of recurrent fractures in the study group was 0％,significantly lower than that in the control group(16.18％),the difference was statistically significant(P＜0.05).Conclusion PVP combined with zole-dronic acid is effective in the treatment of multi-vertebral OVCF.After treatment,patients'self-care ability is improved,and bone density and osteoblast activity increase significantly,without re-fracture.
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