Percutaneous kyphoplasty combined with zoledronic acid infusion in the treatment of osteoporotic thoracolumbar fractures in the elderly

Figures & data

Table 1 Locations of OVCF in the ZOL group, PKP group and PKP+ZOL group

Locations	ZOL	PKP	PKP+ZOL
T11	2	3	2
T12	9	11	8
L1	15	16	13
L2	5	4	4
L3	1	0	2
Total	32	34	29

Notes: T11: the 11th thoracic vertebra; T12: the 12th thoracic vertebra; L1: the 1st lumbar vertebra; L2: the 2nd lumbar vertebra; L3: the 3rd lumbar vertebra.

Abbreviations: OVCF, osteoporotic vertebral compression fracture; PKP, percutaneous kyphoplasty; ZOL, zoledronic acid.

Table 2 Demographic characteristics of ZOL group, PKP group and PKP+ZOL group

Variable	ZOL	PKP	PKP+ZOL	P-value
Number	32	34	29
Age (years)	78.03±5.98	76.65±4.86	77.72±5.58	0.56
Female, n (%)	15 (46.87%)	16 (47.05%)	13 (44.82%)	0.87
BMI (kg/m^2)	30.63±2.99	31.51±3.25	30.29±3.11	0.27
BMD T-scores	−3.67±0.59	−3.80±0.67	−3.51±0.47	0.15
VAS	7.43±0.98	7.23±1.04	7.75±1.02	0.13
ODI (%)	37.00±2.03	38.50±3.21	37.99±2.11	0.06

Note: Data are presented as mean±SD or n (%), and P<0.05 was considered statistically significant.

Abbreviations: BMD, bone mineral density; BMI, body mass index; ODI, Oswestry Disability Index; PKP, percutaneous kyphoplasty; VAS, Visual Analog Scale; ZOL, zoledronic acid.

Figure 1 Vertebral body height before and after PKP and/or ZOL infusion.

Notes: Data are presented as mean±SD. *P<0.05 PKP group vs ZOL group; **P<0.05 PKP+ZOL group vs ZOL group; ^#P<0.05 PKP+ZOL group vs PKP group. Pre: before PKP and/or ZOL infusion; post: after PKP and/or ZOL infusion.
Abbreviations: PKP, percutaneous kyphoplasty; ZOL, zoledronic acid.

Figure 2 Kyphotic wedge angle before and after PKP and/or ZOL infusion.

Notes: Data are presented as mean±SD. *P<0.05 PKP group vs ZOL group; **P<0.05 PKP+ZOL group vs ZOL group; ^#P<0.05 PKP+ZOL group vs PKP group. Pre: before PKP and/or ZOL infusion; post: after PKP and/or ZOL infusion.

Abbreviations: PKP, percutaneous kyphoplasty; ZOL, zoledronic acid.

Figure 3 A 71-year-old female patient with T11 OVCF who received the combination treatment of PKP and ZOL infusion.

Notes: (A–C) The posteroanterior radiograph of thoracolumbar spine preoperatively, 1 year postoperatively and 2 years postoperatively. (D–F) The lateral radiograph thoracolumbar spine preoperatively, 1 year postoperatively and 2 years postoperatively.
Abbreviations: OVCF, osteoporotic vertebral compression fracture; PKP, percutaneous kyphoplasty; ZOL, zoledronic acid.

Figure 4 BMD T-scores at lumbar spine before and after PKP and/or ZOL infusion.

Notes: Data are presented as mean±SD. *P<0.05 ZOL group vs PKP group; **P<0.05 PKP+ZOL group vs PKP group; ^#P<0.05 compared with the baseline. Post: after PKP and/or ZOL infusion.
Abbreviations: BMD, bone mineral density; PKP, percutaneous kyphoplasty; ZOL, zoledronic acid.

Figure 5 VAS before and after PKP and/or ZOL infusion.

Notes: Data are presented as mean±SD. *P<0.05 PKP group vs ZOL group; **P<0.05 PKP+ZOL group vs ZOL group; ^#P<0.05 compared with the baseline. Pre: before PKP and/or ZOL infusion; post: after PKP and/or ZOL infusion.
Abbreviations: PKP, percutaneous kyphoplasty; VAS, Visual Analog Scale; ZOL, zoledronic acid.

Figure 6 ODI before and after PKP and/or ZOL infusion.

Notes: Data are presented as mean±SD. *P<0.05 PKP+ZOL group vs ZOL group; **P<0.05 PKP group vs ZOL group; ^#P<0.05 PKP+ZOL group vs PKP group. Pre: before PKP and/or ZOL infusion; post: after PKP and/or ZOL infusion.
Abbreviations: ODI, Oswestry Disability Index; PKP, percutaneous kyphoplasty; ZOL, zoledronic acid.

Table 3 Complications of PKP and ZOL infusion

	PKP	PKP+ZOL	ZOL	P-value
Cement leakage, n (%)	6 (17.6)	4 (13.8)	0 (0)	0.67
RVF, n (%)	5 (14.7)	0 (0)	0 (0)	0.03
AE, n (%)		12 (35.3)	12 (41.4)	0.62
Flu-like symptoms		5 (14.7)	4 (13.8)	0.67
Fever		1 (2.9)	2 (6.9)	0.46
Headache		2 (5.9)	2 (6.9)	0.87
Nausea		2 (5.9)	1 (3.4)	0.65
Myalgia		1 (2.9)	2 (6.9)	0.46
Arthralgia		1 (2.9)	1 (3.4)	0.91

Note: P<0.05 was considered statistically significant.

Abbreviations: AE, adverse event; PKP, percutaneous kyphoplasty; RVF, recompression vertebral fracture; ZOL, zoledronic acid.