scholarly journals Effectiveness Analysis of Percutaneous Kyphoplasty Combined with Zoledronic Acid in Treatment of Primary Osteoporotic Vertebral Compression Fractures

2019 ◽  
Vol 1 (22;1) ◽  
pp. 63-68
Author(s):  
Shao-Xiong Xiao
Keyword(s):  
Bone Mineral Density ◽  
Zoledronic Acid ◽  
Treatment Group ◽  
Vertebral Compression Fractures ◽  
Control Group ◽  
P Value ◽  
Osteoporotic Vertebral Compression Fractures ◽  
Mineral Density ◽  
Compression Fractures

Objective: To investigate the therapeutic effectiveness of percutaneous kyphoplasty (PKP) combined with zoledronic acid in treatment of primary osteoporotic vertebral compression fractures. Study Design: A perspective cohort study was conducted at a single institution for patients, who received PKP operation due to primary osteoporotic vertebral compression fracture between January 2014 and January 2015. Setting: According to whether they received postoperative zoledronic acid or not, patients were divided into treatment or control groups, with 30 randomly-selected cases per group. Methods: The visual analogue scale (VAS), which was used to assess the degree of pain, and the bone mineral density, was analyzed at 1-, 6-, and 12-month follow-ups. Results: In general, patients experienced marked pain relief after surgery. No significant difference in pain relief was observed in the control group between the 6 and 12-month followup. In contrast, the VAS score of the treatment group at 12-month follow-up was significantly lower than that at 6-month (P value = 0.03). Moreover, it was also significantly lower than the VAS score in the control group at the 12-month follow-up (P value = 0.0018). The bone mineral density of patients from the treatment group increased significantly and progressively after the surgery (pre-operation versus 6-month follow-up: P value = 0.01; 6-month versus 12-month follow-up: P value < 0.001), and it was also remarkably higher than that of the control group at the 12-month follow-up (P value < 0.0001). Limitations: Patients were collected from a single hospital. The maximum postoperative followup time was 12 months. The sample size was relatively small. Thus, bias could occur in the selection of cases if they are not representative of the population. Conclusion: The combined treatment of zoledronic acid with PKP for primary osteoporotic vertebral compression fractures safely and effectively relieved low back pain, significantly increased bone density, and improved the quality of life. The clinical effectiveness is promising and worthy of further study. Key words: Kyphoplasty, zoledronic acid, primary osteoporotic vertebral compression fractures

scholarly journals Can Additional Facet Joint Block Improve the Clinical Outcome of Kyphoplasty for Acute Osteoporotic Vertebral Compression Fractures?

2021 ◽  
pp. 283-291
Author(s):  
Ding-Jun Hao
Keyword(s):  
Clinical Outcome ◽  
Facet Joint ◽  
Satisfaction Score ◽  
Vertebral Compression Fractures ◽  
Medial Branch ◽  
Osteoporotic Vertebral Compression Fractures ◽  
Mineral Density ◽  
Compression Fractures ◽  
Percutaneous Kyphoplasty

Background: Percutaneous kyphoplasty (PKP) has been reported to provide a favorable analgesic effect for pain caused by osteoporotic vertebral compression fractures (OVCFs). However, a systematic review demonstrated that pain relief was only reported for approximately 86% of kyphoplasty treatments. Objectives: To explore whether an additional facet joint block (FJB) can minimize pain and improve the clinical outcome of PKP in patients with acute OVCFs. Study Design: Prospective study. Setting: All data were from Honghui Hospital in Xi’an. Methods: According to the inclusion and exclusion criteria, 194 patients were eventually included in our study; they were randomly divided into 2 groups of 97 patients each and treated with either PKP + FJB or PKP alone. Follow-up consultations were scheduled 1 day, 3 days, 1 week, 1 month, 3 months, and 1 year postoperatively; the demographic characteristics, related surgical information, and complications observed within both groups were recorded. The clinical evaluation parameters included the intraoperative satisfaction score, the Visual Analog Scale (VAS) score, and the Oswestry Disability Index (ODI). Results: A total of 171 patients (61 men and 110 women; age range: 62–85 years) completed the full postoperative follow-up schedule, with 83 patients in the PKP + FJB group and 88 in the PKP group. No significant differences were observed in the genders, ages, preoperative bone mineral density, surgical levels, or volume of cement injected between the 2 groups (P > 0.05, respectively). The average duration of the surgeries in the PKP + FJB group was slightly longer than that in the PKP group (35.5 ± 4.8 min vs. 31.8 ± 4.3 min; P = 0.038), and in terms of the clinical outcomes, the average intraoperative satisfaction score was significantly higher in the PKP + FJB group (8.6 ± 1.1 vs. 6.3 ± 1.3; P < 0.001). Compared with the preoperative data, significant improvements in the VAS scores of back pain and ODI were observed at each follow-up interval (P < 0.05, respectively). These scores were significantly higher in the PKP + FJB group than in the PKP group; however, this was only observed within the first month after the procedure. Limitations: A single-center noncontrol study. Conclusions: The addition of an FJB (which in our study involved a unique combination of ropivacaine, prednisolone, and vitamin B12) improved the short-term clinical outcome of PKP for acute OVCFs. The local anti-inflammatory and analgesic effects on the facet joints resulted in higher intraoperative satisfaction and lower VAS and ODI scores for the first postoperative month when compared with the PKP group. Key words: Osteoporotic vertebral compression fracture, pain, posterior elements, percutaneous kyphoplasty, facet joint block, medial branch

scholarly journals The Lasting Effect of Discontinuing Zoledronic Acid On Periprosthetic Bone Mineral Density Five Years After Total Hip Arthroplasty

2021 ◽  
Author(s):  
Allen Herng Shouh Hsu ◽  
Chun-Hsien Yen ◽  
Yu-Der Lu ◽  
Feng-Chih Kuo ◽  
Cheng-Ta Wu ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Renal Function ◽  
Zoledronic Acid ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Control Group ◽  
Mineral Density ◽  
Short Term ◽  
Periprosthetic Bone ◽  
Lasting Effect

Abstract Background: Previous study has shown that a short-term use of zoledronic acid (ZA) after cementless total hip arthroplasty (THA) significantly increases bone mineral density (BMD) over the proximal femur and inhibits bone turnover markers (BTMs) after two years. However, could the discontinuation of ZA have a lasting effect is of interest.Method: This is an extension study of a two-year prospective randomized controlled trial on 54 cementless THA treated with either two doses of ZA or placebo. We compared BTMs [alkaline phosphatase (ALP); osteocalcin (OC); procollagen 1 intact N-terminal propeptide (P1NP)], serum calcium, renal function, radiological findings, and functional outcomes (Harris hip score and UCLA activity score) from baseline to 5 years post-THA in 49 patients, and periprosthetic BMD of the seven Gruen zones in 19 patients.Result: All patients had well-functioning hip prostheses, normal renal function, and normal serum calcium levels at 5-year follow-up. At the fifth year, the BMD levels were not statistically different between the two groups, but the change in BMD from baseline (BMD change ratios) in ZA group were significantly increased in zone 2, 4, and 6 as compared with control group. Parallel to that, in ZA group, levels of ALP were significantly lower at the fifth year; OC were significantly lower at the second and the fifth year; P1NP were significantly lower from 6 weeks to 2 years as compared with those in control group.Conclusion: This study demonstrates the lasting effect of a two-dose ZA given within one year after THA on bone metabolism and periprosthetic BMD at five years. The short-term dosing of ZA followed by a 4-year drug holiday had no adverse events and resulted in significant inhibition of periprosthetic bone loss and BTMs.Trial Registration:This extension study on a randomized, open label, single-center clinical trial was conducted under Institutional Review Board of Chang Gung Memorial Hospital Protocol Records 98-1150A3; 105-1296C1; 105-7004D, and was registered July 19th, 2016 on public registry ClinicalTrials.gov trial registration number NCT02838121.

scholarly journals Vertebroplasty and kyphoplasty: complementary tecniques for the treatment of painful osteoporotic vertebral compression fractures

2009 ◽  
Vol 8 (1) ◽  
pp. 57-62 ◽  
Author(s):  
Alessio Lovi ◽  
Marco Teli ◽  
Alessandro Ortolina ◽  
Francesco Costa ◽  
Maurizio Fornari ◽  
...  
Keyword(s):  
Bone Biopsy ◽  
Treatment Algorithm ◽  
Vertebral Compression Fractures ◽  
Intractable Pain ◽  
Osteoporotic Vertebral Compression Fractures ◽  
Compression Fractures ◽  
Complementary Techniques ◽  
Similar Good ◽  
A Prospective Study

OBJECTIVE: in a prospective study, we aimed to evaluate the potential use of kyphoplasty (KP) and vertebroplasty (VP) as complementary techniques in the treatment of painful osteoporotic vertebral compression fractures (VCFs). METHODS: after one month of conservative treatment for VCFs, patients with intractable pain were offered treatment with KP or VP according to a treatment algorithm that considers time from fracture (Ät) and amount of Vertebral Body Collapse (VBC). Bone biopsy was obtained intraoperatively to exclude patients affected by malignancy or osteomalacia. RESULTS: hundred and sixty-four patients were included according to the above criteria. Mean age was 67.6 years. Mean followup was 33 months. Ten patients (6.1%) were lost to follow-up and 154 reached the minimum two years follow-up. 118 (69.5%) underwent VP and 36 (30.5%) underwent KP. Complications affected five patients treated with VP, whose one suffered a transient intercostal neuropathy and four a subsequent VCF (two at adjacent level). Results in terms of VAS and Oswestry scores were not different among treatment groups. CONCLUSION: in conclusion, at an average follow-up of almost 3 years from surgical treatment of osteoporotic VCFs, VP and KP show similar good clinical outcomes and appear to be complementary techniques with specific different indications.

Sign in / Sign up

Export Citation Format

Share Document