Between June 2010 and June 2011, 176 patients were divided into 2 groups: a group with spinal metastasis of solid tumors (n=157) and a group with multiple myeloma (n=19). Both groups were further divided into 2 subgroups: a group receiving zoledronic acid before surgery and a control group. The zoledronic acid subgroup of the solid tumors group was group A (n=81), the control subgroup of the solid tumors group was group B (n=76), the zoledronic acid subgroup of the multiple myeloma group was group C (n=10), and the control subgroup of the multiple myeloma group was group D (n=9). The average intraoperative blood loss during spinal surgery was as follows: 1311±691 mL in group A and 1752±740 mL in group B (P=0.000) and 1994±810 mL in group C and 3134±795 mL in group D (P=0.000). Patients receiving zoledronic acid before surgery had significantly less intraoperative bleeding than those who did not receive it. Preoperative use of zoledronic acid can effectively reduce intraoperative bleeding during surgery for the treatment of spinal tumors.