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01.12.2013 | Research article | Ausgabe 1/2013 Open Access

BMC Musculoskeletal Disorders 1/2013

Reduction of the domino effect in osteoporotic vertebral compression fractures through short-segment fixation with intravertebral expandable pillars compared to percutaneous kyphoplasty: a case control study

Zeitschrift:
BMC Musculoskeletal Disorders > Ausgabe 1/2013
Autoren:
Jui-Yang Hsieh, Chung-Ding Wu, Ting-Ming Wang, Hsuan-Yu Chen, Chui-Jia Farn, Po-Quang Chen
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1471-2474-14-75) contains supplementary material, which is available to authorized users.

Competing interests

We declare that we have no competing financial or non-financial interests in relation to this manuscript.

Authors’ contributions

PQC took part in study conception and design, data acquisition, drafting of the article, and revision of the article. JYH took part in study conception and design, statistical analyses, interpretation of the results, and implementation of the article. CDW, TMW, HYC and CJF participated in study conception and design, as well as execution of the study. All authors approved the final version.

Abstract

Background

Osteoporotic vertebral compression fracture is the leading cause of disability and morbidity in elderly people. Treatment of this condition remains a challenge. Osteoporotic vertebral compression fractures can be managed with various approaches, but each has limitations. In this study, we compared the clinical outcomes obtained using short-segment fixation with intravertebral expandable pillars (I-VEP) to those obtained with percutaneous kyphoplasty in patients who had suffered vertebral compression fractures.

Methods

The study included 46 patients with single-level osteoporotic thoracolumbar fractures. Twenty-two patients in Group I underwent short-segment fixation with I-VEP and 24 patients in Group II underwent kyphoplasty. All patients were evaluated pre- and postoperatively using a visual analogue scale, anterior height of the fractured vertebra, and kyphotic angle of the fractured vertebra. The latter 2 radiological parameters were measured at the adjacent segments as well.

Results

There was no significant difference between the groups in terms of gender or fracture level, but the mean age was greater in Group II patients (p = 0.008). At the 1-year follow-up, there were no significant differences in the visual analogue scale scores, anterior height of the fractured vertebra, or the value representing anterior height above the fractured vertebra and kyphotic angle below the fractured vertebra, after adjusting for the patients’ gender, fracture level, and age. When considered separately, the anterior height below the fractured vertebra was significantly higher and the kyphotic angle above the fractured vertebra was significantly smaller in Group I than in Group II (p = 0.029 and p = 0.008, respectively). The kyphotic angle of the fractured vertebra was significantly smaller in Group II than in Group I (p < 0.001).

Conclusions

In older individuals with vertebral compression fractures, kyphoplasty restored and maintained the collapsed vertebral body with less kyphotic deformity than that induced by short-segment fixation with I-VEP. Short-segment fixation with I-VEP was more effective in maintaining the integrity of adjacent segments, which prevented the domino effect often observed in patients with osteoporotic kyphotic spines.
Zusatzmaterial
Authors’ original file for figure 1
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Authors’ original file for figure 9
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