Journal of orthopaedics · 2025
Effect of zoledronic acid on recurrent vertebral fractures after percutaneous vertebroplasty.
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Zhao Shengsheng, Lin Yuzhi, Lin Yanhong, Li Ruizhong, Chen Dongsheng, Liang Daochen
Аннотация
OBJECTIVE: To evaluate the effect of zoledronic acid (ZA) infusion after percutaneous vertebroplasty (PVP) on the recurrence of osteoporotic vertebral compression fractures (OVCFs).
METHODS: A retrospective analysis included 233 elderly OVCF patients from Zhongshan People's Hospital (January 2021-July 2025) who experienced a secondary fracture after initial PVP with or without ZA. Patients were divided into a control group (PVP alone, n = 112) and a combination group (PVP plus ZA, n = 121). Intergroup comparisons covered vertebral status, pain intensity, bone metabolism markers, lumbar bone mineral density (BMD), and time to second fracture at both initial and subsequent admissions.
RESULTS: Cox regression analysis indicated that postoperative ZA, number of vertebral fractures, and bone cement volume significantly influenced time to subsequent fracture (P < 0.05). Adjuvant ZA, single-level fracture, and moderate cement volume were associated with delayed recurrence. At secondary fracture, the combination group showed significantly higher lumbar BMD and longer fracture time interval than controls (P < 0.001). Serum levels of procollagen type 1 N-terminal propeptide (PINP), β-Crosslaps (β-CTX), and osteocalcin (OC) were significantly lower in the combination group compared to both baseline and control levels at secondary fracture (P < 0.001). In contrast, parathyroid hormone (PTH) levels were significantly elevated relative to both initial values and concurrent controls (P < 0.001).
CONCLUSION: Post-PVP ZA administration improved BMD, delayed secondary fractures, and reduced bone turnover in OVCF patients, thereby promoting better clinical outcomes. An appropriate bone cement volume also contributed to prolonged fracture-free intervals.
METHODS: A retrospective analysis included 233 elderly OVCF patients from Zhongshan People's Hospital (January 2021-July 2025) who experienced a secondary fracture after initial PVP with or without ZA. Patients were divided into a control group (PVP alone, n = 112) and a combination group (PVP plus ZA, n = 121). Intergroup comparisons covered vertebral status, pain intensity, bone metabolism markers, lumbar bone mineral density (BMD), and time to second fracture at both initial and subsequent admissions.
RESULTS: Cox regression analysis indicated that postoperative ZA, number of vertebral fractures, and bone cement volume significantly influenced time to subsequent fracture (P < 0.05). Adjuvant ZA, single-level fracture, and moderate cement volume were associated with delayed recurrence. At secondary fracture, the combination group showed significantly higher lumbar BMD and longer fracture time interval than controls (P < 0.001). Serum levels of procollagen type 1 N-terminal propeptide (PINP), β-Crosslaps (β-CTX), and osteocalcin (OC) were significantly lower in the combination group compared to both baseline and control levels at secondary fracture (P < 0.001). In contrast, parathyroid hormone (PTH) levels were significantly elevated relative to both initial values and concurrent controls (P < 0.001).
CONCLUSION: Post-PVP ZA administration improved BMD, delayed secondary fractures, and reduced bone turnover in OVCF patients, thereby promoting better clinical outcomes. An appropriate bone cement volume also contributed to prolonged fracture-free intervals.