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

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.

[1]  Chunde Li,et al.  Effects of rosuvastatin and zoledronic acid in combination on the recovery of senile osteoporotic vertebral compression fracture following percutaneous vertebroplasty , 2020, The Journal of international medical research.

[2]  Lin Zhang,et al.  A Comparison of Percutaneous Vertebroplasty Versus Conservative Treatment in Terms of Treatment Effect for Osteoporotic Vertebral Compression Fractures: A Meta-Analysis , 2020, Surgical innovation.

[3]  Yang-Rae Ma,et al.  Effects of teriparatide versus percutaneous vertebroplasty on pain relief, quality of life and cost-effectiveness in postmenopausal females with acute osteoporotic vertebral compression fracture: A prospective cohort study. , 2019, Bone.

[4]  Wencheng Yang,et al.  Functional outcomes and new vertebral fractures in percutaneous vertebroplasty and conservative treatment for acute symptomatic osteoporotic vertebra compression fractures. , 2019, World neurosurgery.

[5]  Peng Liu,et al.  Causes of Residual Back Pain at Early Stage After Percutaneous Vertebroplasty: A Retrospective Analysis of 1,316 Cases. , 2019, Pain physician.

[6]  Jipeng Song,et al.  Clinical research about the improved PVP method in treatment of acute osteoporotic vertebral compression fractures , 2019, Journal of orthopaedic surgery.

[7]  Y. Wang,et al.  Percutaneous vertebroplasty versus non-operative treatment for osteoporotic vertebral compression fractures: a meta-analysis of randomized controlled trials , 2019, Osteoporosis International.

[8]  Peng Li,et al.  The clinical effect of kyphoplasty using the extrapedicular approach in the treatment of thoracic osteoporotic vertebral compression fracture. , 2019, World neurosurgery.

[9]  B. Liang,et al.  Study on Zoledronic Acid Reducing Acute Bone Loss and Fracture Rates in Elderly Postoperative Patients with Intertrochanteric Fractures , 2019, Orthopaedic surgery.

[10]  T. Zhang,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 , 2019, Osteoporosis International.

[11]  Yi-chun Xu,et al.  A dual-label time-resolved fluorescence immunoassay for screening of osteoporosis based on simultaneous detection of C-terminal telopeptide (β-CTX) and aminoterminal propeptide (P1NP) of type I procollagen , 2019, Scandinavian journal of clinical and laboratory investigation.

[12]  D. Yin,et al.  Study on diagnostic value of P1NP and β-CTX in bone metastasis of patients with breast cancer and the correlation between them. , 2019, European review for medical and pharmacological sciences.

[13]  Y. Qiu,et al.  Global sagittal alignment in elderly patients with osteoporosis and its relationship with severity of vertebral fracture and quality of life , 2018, Archives of Osteoporosis.

[14]  B. Liu,et al.  Clinical Efficacy Analysis of Percutaneous Kyphoplasty Combined with Zoledronic Acid in the Treatment and Prevention of Osteoporotic Vertebral Compression Fractures , 2018, Journal of investigative surgery : the official journal of the Academy of Surgical Research.

[15]  Tzung-Yi Tsai,et al.  Earlier Vertebroplasty for Osteoporotic Thoracolumbar Compression Fracture May Minimize the Subsequent Development of Adjacent Fractures: A Retrospective Study. , 2018, Pain physician.

[16]  F. Cicuttini,et al.  A protocol for a multicentre, randomised, double-blind, placebo-controlled trial to compare the effect of annual infusions of zoledronic acid to placebo on knee structural change and knee pain over 24 months in knee osteoarthritis patients – ZAP2 , 2018, BMC Musculoskeletal Disorders.

[17]  Yuehua Wu,et al.  The risk factors of vertebral refracture after kyphoplasty in patients with osteoporotic vertebral compression fractures: a study protocol for a prospective cohort study , 2018, BMC Musculoskeletal Disorders.

[18]  K. Hu,et al.  Comparison of percutaneous balloon dilation kyphoplasty and percutaneous vertebroplasty in treatment for thoracolumbar vertebral compression fractures. , 2018, European review for medical and pharmacological sciences.

[19]  P. Otáhal,et al.  Effect of Zoledronic Acid and Denosumab in Patients With Low Back Pain and Modic Change: A Proof‐of‐Principle Trial , 2018, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[20]  Heng Wang,et al.  Percutaneous kyphoplasty for the treatment of very severe osteoporotic vertebral compression fractures with spinal canal compromise , 2018, Journal of Orthopaedic Surgery and Research.

[21]  Shixun Li,et al.  Multicenter Study on Observation of Acute‐phase Responses After Infusion of Zoledronic Acid 5 mg in Chinese Women with Postmenopausal Osteoporosis , 2017, Orthopaedic surgery.

[22]  T. Kuroiwa,et al.  Long-term therapeutic effects of vertebroplasty for painful vertebral compression fracture: a retrospective comparative study , 2017, British journal of neurosurgery.

[23]  John D. Roberts,et al.  Effect of Longer-Interval vs Standard Dosing of Zoledronic Acid on Skeletal Events in Patients With Bone Metastases: A Randomized Clinical Trial , 2017, JAMA.

[24]  Gao-Jun Teng,et al.  Risk Prediction of New Adjacent Vertebral Fractures After PVP for Patients with Vertebral Compression Fractures: Development of a Prediction Model , 2017, CardioVascular and Interventional Radiology.

[25]  D. Hao,et al.  A prospective randomized controlled study comparing the pain relief in patients with osteoporotic vertebral compression fractures with the use of vertebroplasty or facet blocking , 2016, European Spine Journal.

[26]  H. Kato,et al.  Risk factors of adjacent vertebral collapse after percutaneous vertebroplasty for osteoporotic vertebral fracture in postmenopausal women , 2016, BMC Musculoskeletal Disorders.

[27]  N. Watts,et al.  AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY CLINICAL PRACTICE GUIDELINES FOR THE DIAGNOSIS AND TREATMENT OF POSTMENOPAUSAL OSTEOPOROSIS - 2016. , 2016, Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists.

[28]  J. Chiras,et al.  Safety and Clinical Effectiveness of Percutaneous Vertebroplasty in the Elderly (≥80 years) , 2016, European Radiology.

[29]  Dong Chan Lee,et al.  Analysis of Risk Factors Causing New Symptomatic Vertebral Compression Fractures After Percutaneous Vertebroplasty for Painful Osteoporotic Vertebral Compression Fractures: A 4-year Follow-up , 2015, Journal of spinal disorders & techniques.

[30]  Liqing Yang,et al.  Efficacy and Safety of Zoledronic Acid and Pamidronate Disodium in the Treatment of Malignant Skeletal Metastasis , 2015, Medicine.

[31]  Li-min Wang,et al.  A prospective study of percutaneous vertebroplasty for chronic painful osteoporotic vertebral compression fracture , 2015, Pain research & management.

[32]  Y. Yan,et al.  Is thoracolumbar fascia injury the cause of residual back pain after percutaneous vertebroplasty? A prospective cohort study , 2015, Osteoporosis International.

[33]  L. Chen,et al.  Is vertebroplasty a risk factor for subsequent vertebral fracture, meta-analysis of published evidence? , 2014, Osteoporosis International.