PMID: 25741039Mar 6, 2015Paper

Combined posterior-anterior surgery for osteoporotic delayed vertebral fracture with neurologic deficit

Nagoya Journal of Medical Science
Hiroaki NakashimaFumihiko Kato

Abstract

With the aging of society, osteoporotic thoracolumbar compression fracture is a concern. This fracture occurs occasionally; however, some cases progress to neural compromise due to delayed vertebral body collapse requiring surgery. Surgical treatment and postoperative care are difficult because of patients' serious comorbidities and poor bone quality, and hence, optimum treatment is not clear, even though some surgical approaches have been reported. There were 35 consecutive patients (5 males and 30 females) with osteoporotic delayed vertebral fractures and associated neurological deficit. Mean age at surgery was 70.7 years (range 60-84 years). Average postoperative follow-up was 3.8 years (range 0.6-11.3 years). All patients experienced a single vertebra collapse, except for 1 with a 2-level collapse of lumbar vertebrae. One thoracic (Th7), 19 thoracolumbar (Th12-L1), and 16 lumbar (L2-5) fractures were treated with combined posterior-anterior surgery. The American Spinal Injury Association (ASIA) impairment scale, activities of daily living (ADL) status, and local sagittal angle were evaluated both before and after surgery. Forty-six percent of all patients showed an improvement of more than 1 grade postoperatively on the ASI...Continue Reading

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