title: The effect of zoledronic acid on the volume of the fusion-mass in lumbar spinal fusion.
abstract: BACKGROUND
  Few studies have explored the effects of bisphosphonates on bony healing in patients undergoing spinal fusion surgery. Most previous studies used animal models and found that bisphosphonate shows negative effects on spinal fusion consolidation. We intended to evaluate the effect of a single-dose of zoledronic acid on the volume of the fusion-mass in lumbar spinal fusion.
  
  
  METHODS
  A retrospective review was carried out on 44 patients with symptomatic degenerative lumbar spinal stenosis who underwent one or two-level posterolateral fusion from January 2008 and January 2011. They were divided into 4 groups: group 1, autograft and zoledronic acid; group 2, allograft and zoledronic acid; group 3, autograft alone; and group 4, allograft alone. Functional radiography and three-dimensional computed tomography scans were used to evaluate and quantify the volume of the fusion-mass. The visual analog scale (VAS), the Oswestry disability index (ODI), and the short form 36 (SF-36) were used to evaluate the clinical outcomes.
  
  
  RESULTS
  The mean volume of the fusion-mass per level was 8,814 mm(3), 8,035 mm(3), 8,383 mm(3), and 7,550 mm(3) in groups 1, 2, 3, and 4, respectively, but there were no significant differences between the groups (p = 0.829). There were no significant decreases in the volume of the fusion-mass (p = 0.533) in the zoledronic acid groups (groups 1 and 2). The VAS, the ODI, and the SF-36 at the 6-month follow-up after surgery were not significantly different (p > 0.05) among the 4 groups. The VAS, the ODI, and the SF-36 were not correlated with the volume of the fusion-mass (p = 0.120, 0.609, 0.642).
  
  
  CONCLUSIONS
  A single dose of zoledronic acid does not decrease the volume of the fusion-mass in patients undergoing spinal fusion with osteoporosis. Therefore, we recommend that zoledronic acid may be used after spinal fusion in osteoporotic patients.
authors: Department of Orthopaedic Surgery, Guri Hospital, Hanyang University College of Medicine, Guri, Korea.
authors: Ye-Soo
authors: YS
authors: Park
authors: Hong-Sik
authors: HS
authors: Kim
authors: Seung-Wook
authors: SW
authors: Baek
authors: Dong-Yi
authors: DY
authors: Kong
authors: Jeong-Ah
authors: JA
authors: Ryu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D004164:Diphosphonates / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007093:Imidazoles / Q000627:therapeutic use*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000187:drug effects / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000188:drug therapy; D010147:Pain Measurement; D010149:Postoperative Pain; D011788:Quality of Life; D011859:Radiography; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000009:adverse effects / Q000379:methods*; D013130:Spinal Stenosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome; D000077211:Zoledronic Acid
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D007093:Imidazoles; D000077211:Zoledronic Acid
keywords: Bisphosphonate; Fusion-mass; Osteoporosis; Spinal fusion; Zoledronic acid