Retrospective study on the treatment of osteoporotic vertebral compression fractures with alfacalcidol and percutaneous kyphoplasty

Abstract

Objective To evaluate the clinical efficacy of percutaneous kyphoplasty (PKP) combined with alfacalcidol in the treatment of osteoporotic vertebral compression fractures (OVCF), and to explore the impact on bone metabolism and functional recovery. Methods This retrospective study included 120 patients with single-level OVCFs who underwent PKP between January 2021 and January 2023. Patients were divided into two groups: the basic treatment group (BT, n = 60) received standard postoperative care including calcium and vitamin D supplementation; the alfacalcidol group (AFC, n = 60) received additional oral alfacalcidol. Clinical parameters—including bone mineral density (BMD), bone metabolism markers (NMID, P1NP, β-CTX), Visual Analog Scale (VAS) for pain, and Japanese Orthopaedic Association (JOA) scores—were recorded preoperatively, and at 6 and 12 months postoperatively. Results Both groups showed significant postoperative improvement in BMD, VAS, and JOA scores. However, the AFC group demonstrated greater increases in BMD and more pronounced reductions in bone turnover markers at both follow-up points (P < 0.05). Additionally, pain relief and functional recovery were significantly better in the AFC group. No serious adverse events were observed. Conclusion PKP combined with alfacalcidol is more effective than PKP alone in improving bone metabolism, relieving pain, and promoting functional recovery in patients with OVCF. This combination therapy addresses both the structural and metabolic aspects of osteoporosis and may help reduce future fracture risk.