Effect of topical zolendronic acid on spinal fusion of osteoporotic patients:A Randomized clinical trial

Spinal fusion is a surgical method to treat degenerative diseases of the spine. We studied the effect of bone graft soaked with zolendronic acid (ZA) on spinal fusion.

60 patients with degenerative disease, scheduled for spinal fusion were randomly divided into 2 equal groups, receiving either local bone graft or local bone graft plus topical zoledronic acid. The cases were studied with visual analogue scale (VAS), Oswestry low back disability questionnaire, and radiographic bone bridge formation with a 12-months follow-up.

57 patients completed the study: 27 patients in “control group” and 30 patients in “case group”. VAS Score was significantly lower in case group in comparison with control one after 12 months (P value:0.00).In the point of Oswestry low back disability questionnaire score(ODI)score the mean score was decreased significantly in “case group” in comparison with “control group”(P value =0.006). Radiographic grades A or B bone  bridging was more frequently observed in Zoledronic acid group at 12 months post-operation compared with the control group (p value=0.00).

This study demonstrates that addition of Zolendronic Acid to bone grafting in the spinal fusion of elderly people increases the fusion rate and is associated with better clinical and functional outcome.