Comparative Analysis Of The Curative Effect Of Three Bisphosphonate Drugs On Patients After PKP

Objective:This study intends to simultaneously perform surgery and anti-osteoporosis treatment on patients with osteoporosis and vertebral compression fractures.The surgery will be performed by Percutaneous kyphoplasty(PKP).The purpose of comparing the effect difference after treatment is to provide a basis for the subsequent selection of anti-osteoporosis drugs and the formulation of plans for patients after PKP.Methods:A total of 121 patients with osteoporotic vertebral compression fractures who underwent PKP surgery were selected from the Department of Orthopedics,Affiliated Hospital of Hebei University from November 2017 to January 2019.According to the patient's treatment wishes,patients were automatically entered into the alendronate sodium treatment group(42 cases in group A),ibandronate sodium treatment group(39 cases in group B),and zoledronate sodium treatment group(40 cases in group C).Since PKP surgery,group A: take alendronate sodium tablets(70mg/tablet,1 time/week)half an hour before meals in the morning for one year;group B:intravenous infusion of ibandronate sodium(2mg/2ml,1 time/3 months),treatment for one year;Group C: intravenous infusion of zoledronate sodium(5mg/100 ml,1 time/year).At the same time,three groups of patients were instructed to take 600 mg of Calci D tablets and 0.25 ug of calcitriol once a day.The visual analogue scale(VAS)scores and the lumbar spine dysfunction index(The Oswestry Disability Index,ODI)of the three groups of patients were counted before operation,2 hours after operation,6 months after operation,and 12 months after operation.Statistics of bone mineral density of the three groups of patients before operation,6 months and 12 months after operation.The height of the anterior edge of the vertebral body of the three groups of patients before operation,the next day after operation,and 6 months and 12 months after operation were calculated.The incidence of adjacent vertebral fracture(AVF)in the three groups at the last follow-up was calculated.Acute-phase response(APR)incidence and treatment compliance rate during treatment and follow-up cycles.Use SPSS23.0 software to statistically analyze the above data.The measurement data are described by mean±standard deviation(X±S).The comparison between groups is by one-way analysis of variance,the comparison between groups is by paired sample T test,and the comparison of rates is by chi-square.test.Statistical analysis method: P<0.05 means significant difference and statistical significance.Results: 1.VAS score: within the group: the three groups of patients improved 2 hours after surgery compared with preoperatively,the difference was statistically significant;VAS scores continued to decline at 6 and 12 months after surgery compared with 2 hours after surgery,but The rate of decline slowed down and was statistically significant;VAS scores in groups A and C were statistically significant at 6 months and 12 months after surgery,while the values ??in group C were lower;there was no statistical significance in group B.Between groups: VAS scores before operation,2 hours after operation,and 6 months after operation were not different among the three groups.Group C had the lowest VAS score at the 12-month follow-up,and it was statistically significant.2.ODI index: within the group: the ODI index of the three groups of patients 2 hours after the operation was significantly lower than that before the operation,with statistical significance.The score also decreased at 6 months after operation compared with 2 hours after operation,P<0.05,but the range was significantly reduced compared with 2 hours after operation.There was no statistical significance at 6 months after operation and 12 months after operation.Between groups: There was no significant difference in the ODI index of each follow-up node between the three groups of patients,and there was no statistical significance,but the values ??of group C were lower than those of groups A and B.3.Bone mineral density: within the group: 6 months and 12 months follow-up data of the three groups of patients were improved compared with that before operation,P<0.05,which was statistically significant.There was no difference between groups A and B at 6 and 12 months after surgery,but there was a difference in group C,which was statistically significant.Comparison between groups: There was no difference in the follow-up data of the three groups before and 6months after the operation.There was statistical significance at 12 months after the operation.The bone density of the patients in group C was the highest.4.Vertebral body height: within the group: the vertebral body height of the three groups of patients the next day after surgery was significantly different from that before surgery,which was statistically significant.There was no significant difference between 6 months and 12 months after operation and the day after operation.Between groups: There was no significant difference in each follow-up node of the three groups,which was not statistically significant.5.AVF incidence: at the last follow-up,the three groups of patients all had recurrence of vertebral body fractures,there was no significant difference between the groups,and there was no statistical significance.6.Adverse drug reactions: The data of the three groups are statistically significant after comparison.The incidence of patients in group C is the lowest,group A is the highest,and group B is in the middle.7.Treatment compliance: The treatment compliance rate of the zoledronate sodium group was the highest,which was statistically significant.Conclusion: Alendronate sodium,ibandronate sodium,and zoledronate can effectively increase the bone density of patients after PKP,reduce the VAS score and ODI index,maintain the height of the postoperative vertebral body,and can comprehensively improve the bone density of patients.The adverse effects of cytoporosis can be recommended in the follow-up treatment of patients after PKP.However,the results of this test show that zoledronic acid is more effective in increasing bone density than alendronate and ibandronate,and it can continue to play an anti-osteoporotic effect for a longer period of time,and it can reduce the VAS score.It also performed better than the other two groups in terms of the incidence of adverse reactions and medication compliance.If there are no special contraindications,zoledronate can be used as a bisphosphonate in PKP patients for postoperative anti-osteoporosis The preferred choice.