Percutaneous Kyphoplasty combined with different anti-osteoporosis drugs for the treatment of osteoporotic vertebral compression fractures.

OBJECTIVE

To explore the effectiveness of percutaneous kyphoplasty (PKP) combined with different anti-osteoporosis drugs in the treatment of osteoporotic vertebral compression fractures (OVCF) by assessing bone mineral density, pain, lumbar functional recovery, and incidence of vertebral refractures after the combined therapy.

METHODS

In this single-center retrospective study, medical records of 138 patients with OVCF who underwent PKP in the Third Hospital of Hebei Medical University between January 2021 and October 2022 were retrospectively analyzed. Among them, 41 patients treated with calcium and alfacalciferol supplementation after PKP (Group-A), 58 patients treated with calcium and calcitonin after PKP (Group-B), and 39 patients treated with calcium, calcitonin, and alendronate sodium after PKP (Group-C). Bone mineral density, pain, lumbar functional recovery, and incidence of vertebral refractures in the three groups were compared before and after PKP.

RESULTS

At six and 12 months after PKP, bone density T-values of Group-B and Group-C were significantly higher than Group-A (P<0.05). The visual analogue scale (VAS) scores of Group-B and Group-C were significantly lower than Group-A (P<0.05). At 12 months after PKP, T-value of bone density in Group-C was significantly higher, while the VAS score was significantly lower than Group-B; At six months after PKP, the Cobb angle in Group-B and Group-C was significantly lower than Group-A (P<0.05). At 12 months after PKP, Oswestry disability index (ODI) and Cobb angle of Group-B and Group-C were significantly lower than Group-A, and the lowest in Group-C. The extent of vertebral loss in Group-C was significantly lower than Groups A and B (P<0.05).

CONCLUSIONS

In the treatment of osteoporotic vertebral compression fractures after percutaneous kyphoplasty, a combination of calcium therapy with calcitonin and alendronate sodium had a positive effect, which may effectively improve bone density, pain, and functional status, and reduce the incidence of vertebral body fractures.