Effect of Preoperative Zoledronic Acid Administration on Pain Intensity after Percutaneous Vertebroplasty for Osteoporotic Vertebral Compression Fractures.

Weiran Hu,Guangquan Zhang,Xinge Shi,Hongqiang Wang,Kai Zhang,Yanzheng Gao,Yuepeng Song,Shuai Xing

doi:10.1155/2020/8039671

Weiran Hu, Guangquan Zhang + Show 6 more

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https://doi.org/10.1155/2020/8039671

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Abstract

Introduction This study aimed to compare and analyze the effect of preoperative zoledronic acid (ZOL) administration on pain intensity after percutaneous vertebroplasty (PVP) for osteoporotic vertebral compression fracture (OVCF). Methods The study included 242 patients with OVCFs who underwent PVP in our hospital between January 2015 and June 2018. The patients were randomly assigned to either a ZOL group (n = 121) or a control group (n = 121). The patients in the ZOL group were treated preoperatively with intravenous infusion of 5 mg ZOL. Those in the control group were treated without ZOL. All the patients were followed up for 1 year. Results No statistically significant differences in age, sex, weight, and body mass index (BMI) were found between the two groups. During the follow-up period, the visual analog scale score and Oswestry dysfunction index score in the ZOL group were lower than those in the control group. The bone mineral density at 6 or 12 months after treatment was significantly higher and the levels of the bone metabolism markers were significantly lower in the ZOL group than in the control group (P < 0.05 for both). Two patients in the treatment group had new vertebral fractures, whereas 13 patients in the control group had new vertebral fractures, which translate to recompression vertebral fracture incidence rates of 1.7% and 10.7%, respectively. The incidence rate of mild adverse reactions was significantly higher in the ZOL group than in the control group, but all the cases were endurable. Conclusion Intravenous infusion of ZOL before PVP can effectively reduce postoperative pain intensity, reduce bone loss, increase bone density, reduce the risk of refracture, and improve patient quality of life.

Highlights

Osteoporotic vertebral compression fracture (OVCF) is one of the most common fractures in patients with osteoporosis
Zoledronic acid (ZOL) administration can effectively increase lumbar bone density and reduce the risk of vertebral fracture in patients with osteoporosis, which has been reported in the literature [2]. us, it may have great significance in consolidating the surgical treatment effect of percutaneous vertebroplasty (PVP) and preventing new vertebral fractures
Bone mineral content was determined in accordance with the American Association of Clinical Endocrinologists and American College of Endocrinology Clinical Practice Guidelines for the Diagnosis and Treatment of Postmenopausal Osteoporosis 2016 [3]

Summary

Introduction

Osteoporotic vertebral compression fracture (OVCF) is one of the most common fractures in patients with osteoporosis. Most OVCFs are stable and asymptomatic vertebral fractures that do not require open surgical therapy. PVP still has some problems such as postoperative residual pain in the lower back and the development of new vertebral fractures, which may cause other problems in patients. A study by Zhong et al suggested that 12.9% of patients had new fractures within 1 year after PVP [1]. Zoledronic acid (ZOL) administration can effectively increase lumbar bone density and reduce the risk of vertebral fracture in patients with osteoporosis, which has been reported in the literature [2]. Us, it may have great significance in consolidating the surgical treatment effect of PVP and preventing new vertebral fractures Zoledronic acid (ZOL) administration can effectively increase lumbar bone density and reduce the risk of vertebral fracture in patients with osteoporosis, which has been reported in the literature [2]. us, it may have great significance in consolidating the surgical treatment effect of PVP and preventing new vertebral fractures

Methods

Results

Conclusion