Open kyphoplasty for management of severe osteoporotic spinal fractures.

Abstract

OBJECTIVE:

Osteoporotic compression fractures, which can lead to neurological complications in some cases, are an increasingly frequent occurrence. These lesions require decompression surgery with or without spinal stabilization procedures. In this article, we present the preliminary results obtained using open kyphoplasty, a new method of treating vertebral compression disorders.

METHODS:

Sixteen patients were included in this prospective study, and a total of 17 vertebrae were treated. All of the patients had vertebral compression fractures associated with neurological disorders. The surgical treatment consisted of open kyphoplasty after laminectomy and decompression. Short-segment vertebral osteosynthesis was also performed in patients with pronounced local kyphosis. Pain was rated at clinical assessments, and radiological assessments were performed to determine the restored vertebral height and the correction of any local vertebral kyphosis.

RESULTS:

Analysis of the results obtained using this method showed that vertebral height was significantly improved (P < 0.001) and local kyphosis was significantly reduced (P < 0.001). The mean operating time was 90 minutes. The neurological status of all patients improved; 14 patients recovered completely from their neurological symptoms. The last 2 patients had associated neurological disease but were able to walk. There were 2 superficial postoperative infections.

CONCLUSION:

This method for treating severe osteoporotic compression fractures associated with neurological disorders gives successful results and can be used to treat neurological compression fractures while consolidating the vertebral body. Therefore, this less invasive approach seems to be particularly useful for treating compression fractures in the thoracolumbar spine junction in elderly patients who often have comorbidities.

• Authors: Stéphane Fuentes, Benjamin Blondel, Philippe Metellus, Tarek Adetchessi, Jean Gaudart, Henry Dufour
• Journal: Neurosurgery (Neurosurgery) Vol. 64 Issue 5 Suppl 2 Pg. 350-4; discussion 354-5 (May 2009) ISSN: 1524-4040 [Electronic] United States
• PMID: 19404113 (Publication Type: Journal Article)

Topics

• Adult
• Age Factors
• Aged
• Aged, 80 and over
• Decompression, Surgical (methods)
• Female
• Fractures, Compression (etiology, pathology, surgery)
• Humans
• Laminectomy (methods)
• Lumbar Vertebrae (diagnostic imaging, pathology, surgery)
• Male
• Middle Aged
• Osteoporosis (complications)
• Postoperative Complications (etiology)
• Prospective Studies
• Radiography
• Spinal Cord Compression (etiology, pathology, surgery)
• Spinal Fractures (etiology, pathology, surgery)
• Surgical Wound Infection
• Thoracic Vertebrae (diagnostic imaging, pathology, surgery)
• Treatment Outcome
• Vertebroplasty (instrumentation, methods)