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Eur Spine J. 2013 Apr;22(4):883-91. doi: 10.1007/s00586-012-2508-4. Epub 2012 Sep 28.

Surgical patterns in osteoporotic vertebral compression fractures.

Author information

  • 1Division of Spine Surgery, Department of Orthopaedics, PD Hinduja National Hospital, Veer Savarkar Marg, Mahim, Mumbai, 400016 Maharastra, India. sanganpatil9@gmail.com

Abstract

PURPOSE:

To report morphological patterns of osteoporotic vertebral compression fractures (OVCFs) presenting for surgery. To describe surgical options based on fracture pattern. To evaluate clinical and radiological outcome.

METHODS:

Forty consecutively operated OVCFs nonunion patients were retrospectively studied. We define four patterns of OVCFs that needed surgical intervention. Group 1 mini open vertebroplasty (N = 10) no neurologic deficits and kyphotic deformity, but with intravertebral instability and significant radiological spinal canal compromise. Group 2 with neurologic deficits (N = 24) (2A)-transpedicular decompression (TPD) with instrumentation (N = 14). Fracture morphology similar to (1) and localized kyphosis <30° (2B)-pedicle subtraction osteotomy (PSO) with instrumentation (N = 10). Fracture morphology similar to (1) and local kyphosis >30°. Group 3 posterolateral decompression with interbody reconstruction (N = 06) endplate(s) destroyed, with instability at discovertebral junction, with neurologic deficit. Average follow-up was 34 months. VAS, ODI and Cobb angle were recorded at 3, 6, 12 months and yearly.

RESULTS:

There was significant improvement in the clinical (VAS and ODI) scores and radiologic outcome in each group at last follow-up. 30 patients out of 40, had neurologic deficits (Frankel's grade C = 16, Frankel's grade D = 14). The motor power gradually improved to Frankel's grade E. Average duration of surgery was 97 min. Average blood loss was 610 ml.

CONCLUSION:

Different surgical techniques were used to suit different fracture patterns, with good clinical and radiological results. This could be a step forward in devising an algorithm to surgical treatment of OVCF nonunions.

PMID:
23053751
[PubMed - indexed for MEDLINE]
PMCID:
PMC3631027
Free PMC Article

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