Effect Of Zoledronic Acid On Post-lumbar Spinal Fusion In Osteoporosis Patients

Objective To investigate the effect of zoledronic acid(ZA)on post-lumbar spinal fusion for patients with osteoporosis.Methods 94 patients with definite osteoporosis suffering from lumbar degenerative diseases or lumbar fracture accepted post-lumbar spinal fusion in the First Affiliated Hospital of Nanjing Medical University from January 2013 to August 2014.They were divided into ZA group and control group according to whether accepted ZA or not.The patients in ZA group received 5mg intravenous ZA at the third to the fifth day after operation.All patients took in 1000 mg Calcium and 400 IU vitamin D3 since the first day after operation.We observed the Visual analogue scales(VAS),Oswestry disability index(ODI)and Short Form 36(SF-36)scores at postoperative 3,6,12,24 month to evaluate all the patients' clinic efficacy and made assessment of the spinal fusion with X-ray and Computed Tomography(CT)scans.Results 64 patients were completely followed,including 30 patients in ZA group and 34 patients in the control group.The preoperative difference in gender,age,BMI,VAS,ODI and SF-36 scores are not statistically significant between two groups(P>0.05).The VAS and ODI scores decreased rapidly at the postoperative 3 and 6 month,while increased after postoperative 12 month.On the contrary,SF-36 scores increased rapidly at the postoperative 3 and 6 month,while decreased after postoperative 12 month.There was statistically significant difference between two groups at postoperative 12 month,while no significant difference at postoperative 3 and 6 month.The fusion rate at postoperative 6 and 12 month in ZA group was 90% and 92%,75% and 92.86% in control group,respectively.The fusion rate was statistically significant difference between two groups at postoperative 12 month,while no at postoperative 6 month.In the follow-up period,adjacent vertebral compressing fracture occurred to 5 patients in control group,while no patient in ZA group.No pedicle screw loosening was observed in ZA group,while 6 in control group.Conclusions ZA promoted spinal fusion,shortened time of fusion and decreased the risk of adjacent vertebral compressing fracture and the rate of pedicle screw loosening,resulting to the improvement of clinical efficacy and quality of life.