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Erschienen in:

18.05.2016 | Original Paper

Surgical treatment for osteoporotic thoracolumbar vertebral collapse using vertebroplasty with posterior spinal fusion: a prospective multicenter study

verfasst von: Keiichi Katsumi, Toru Hirano, Kei Watanabe, Masayuki Ohashi, Akiyoshi Yamazaki, Takui Ito, Kimihiko Sawakami, Atsuki Sano, Ren Kikuchi, Naoto Endo

Erschienen in: International Orthopaedics | Ausgabe 11/2016

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Abstract

Purpose

The study aimed to investigate the clinical outcomes and limitations after vertebroplasty with posterior spinal fusion (VP+PSF) without neural decompression for osteoporotic vertebral collapse.

Methods

We conducted a prospective multicenter study including 45 patients (12 men and 33 women, mean age: 77.0 years) evaluated between 2008 and 2012. Operation time, blood loss, visual analog scale (VAS) of back pain, neurological status, kyphosis angle in the fused area, and vertebral union of the collapsed vertebra were evaluated.

Results

The mean operation time was 162 min and blood loss was 381 mL. The postoperative VAS score significantly improved, and the neurological status improved in 35 patients (83 %), and none of the remaining patients demonstrated a deteriorating neurological status at two years post-operatively. The mean kyphosis angle pre-operatively, immediately post-operatively, and two years post-operatively was 23.8°, 10.7°, and 24.3°, respectively, and there was no significant difference between the angles pre-operatively and two years post-operatively. The extensive correction of kyphosis >16° was a risk factor for a higher correction loss and subsequent fracture. Union of the collapsed vertebra was observed in 43 patients (95 %) at two years post-operatively.

Conclusions

The present study suggests that spinal stabilization rather than neural decompression is essential to treat OVC. Short-segment VP+PSF can achieve a high union rate of collapsed vertebra and provide a significant improvement in back pain or neurological status with less invasive surgery, but has a limit of kyphosis correction more than 16°.

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Titel: Surgical treatment for osteoporotic thoracolumbar vertebral collapse using vertebroplasty with posterior spinal fusion: a prospective multicenter study
verfasst von: Keiichi Katsumi
Toru Hirano
Kei Watanabe
Masayuki Ohashi
Akiyoshi Yamazaki
Takui Ito
Kimihiko Sawakami
Atsuki Sano
Ren Kikuchi
Naoto Endo
Publikationsdatum: 18.05.2016
Verlag: Springer Berlin Heidelberg
Erschienen in: International Orthopaedics / Ausgabe 11/2016
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-016-3222-3

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Surgical treatment for osteoporotic thoracolumbar vertebral collapse using vertebroplasty with posterior spinal fusion: a prospective multicenter study