Liu Bin, Liu Xiangyang, Chen Yixin, Wang GuoPing, Wang Guohua, Shen Xiongjie, Liu Hongzhe, Liao Xiaoyun
1 Department of Spine Surgery, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, China.
2 Department of Rehabilitation Medicine, Xiangya Hospital, Central South University, Changsha, China.
J Orthop Surg (Hong Kong). 2019 May-Aug;27(2):2309499019847028. doi: 10.1177/2309499019847028.
To observe the clinical effect of zoledronic acid (ZA) in patients with cervical spondylosis and osteoporosis after anterior cervical discectomy and fusion (ACDF) surgery.
All selected patients were divided into the study group and the control group according to the sequence of surgery time. In the study group, 5 mg (100 ml) of ZA was applied intravenously as intervention on the 5 day after ACDF surgery. Patients were followed up regularly after surgery.
Forty-three cases completed the follow-ups (21/22), the neck disability index (NDI) score significantly decreased at the 3rd month after surgery in both groups, it came to a plateau at the 6th month after surgery, and it had some rise at the 12th month after surgery, but the NDI score was lower in the study group at the 12th month after surgery ( p < 0.05). C-telopeptide of type I collagen (CTX) and amino terminal propeptide of type I procollagen of bone turnover markers in the study group showed a downward trend after surgery, among which CTX decreased significantly and no significant changes in the control group. At the 12th month after surgery, the bone mineral density of lumbar spine area in the study group was significantly improved ( p < 0.05). During the 3rd and the 6th month follow-up after surgery, 1/2 osteogenesis rate of the study group was significantly higher ( p < 0.05). However, all patients in the two groups obtained stable fusion at the 12th month follow-up after surgery.
For patients with cervical spondylosis and osteoporosis, intravenous application of ZA after ACDF surgery can shorten the time of cervical osteogenesis, promote local bone graft fusion, and improve the postoperative clinical effect to some extent.
观察唑来膦酸（ZA）对颈椎病合并骨质疏松患者行颈椎前路椎间盘切除融合术（ACDF）后临床疗效的影响。
所有入选患者按手术时间顺序分为研究组和对照组。研究组于ACDF术后第5天静脉应用5mg（100ml）ZA作为干预措施。术后对患者进行定期随访。
43例患者完成随访（21/22），两组患者术后第3个月颈部功能障碍指数（NDI）评分均显著下降，术后第6个月趋于平稳，术后第12个月有所上升，但研究组术后第12个月NDI评分较低（p<0.05）。研究组术后骨转换标志物Ⅰ型胶原C末端肽（CTX）和Ⅰ型前胶原氨基端前肽呈下降趋势，其中CTX显著下降，对照组无明显变化。术后第12个月，研究组腰椎区域骨密度显著改善（p<0.05）。术后第3个月和第6个月随访期间，研究组的1/2成骨率显著更高（p<0.05）。然而，两组所有患者在术后第12个月随访时均获得稳定融合。
对于颈椎病合并骨质疏松患者，ACDF术后静脉应用ZA可缩短颈椎成骨时间，促进局部植骨融合，在一定程度上改善术后临床疗效。
