Objective  To investigate the clinical effects of zoledronic acid in different time periods in the treatment of elderly osteoporotic vertebral compression fractures (OVCFs) after percutaneous kyphoplasty (PKP).

  Methods  Eighty elderly patients with OVCFs were divided into observation group and control group according to random number table method, with 40 cases in each group. Both groups received PKP, the observation group received intravenous infusion of zoledronic acid on the 3rd day after surgery, and the control group received zoledronic acid 1 month after surgery. The height of the injured vertebrae, the change of the Cobb angle of the local vertebrae, the Visual Analogue Scale (VAS) score, the Oswestry disability index (ODI), the bone mineral density (BMD) of the lumbar spine and hip were compared between the two groups before and after surgery. Bone transformation biochemical markers (BTMS) were detected in the two groups, including N-terminal propeptide of typeⅠprocollagen (PINP) and β cross-linked C-telopeptide of typeⅠcollagen (β-CTX). Recurrence of vertebral compression fractures and adverse reactions were recorded in the two groups.

  Results  At 1 month and 3 months after operation, the VAS and ODI scores of the observation group were significantly lower than those of the control group (P < 0.05); At 6 months and 1 year after surgery, the BMD T values of lumbar spine and hip in observation group were significantly higher, PINP and β-CTX were significantly lower than those in the control group (P < 0.05).

  Conclusion  Early use of zoledronic acid after PKP in elderly OVCFs patients can reduce pain, restore vertebral height and correct kyphosis angle, and have advantages in improving bone mineral density and bone metabolism.