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Background A considerable propotion of patients with cancer got thoracolumbar vertebral metastatic epidural spinal cord compression, which affected their quality of life. Traditional surgical management involves early decompression with concomitant spine stabilization with long instrumentation. However, complications are caused by massive blood loss and long operation time. This study aimed to compare the safety and efficacy of short posterior instrumentation with kyphoplasty and the traditional method for thoracolumbar metastatic epidural spinal cord compression. Methods Between January 2004 and December 2015, a retrospective study was conducted on 120 patients with metastatic epidural spinal cord compression from T6 to L5 and divided into 2 groups: short posterior instrumentation with the balloon kyphoplasty group (group I, n = 50) and the long posterior instrumentation group (group II, n = 70). The clinical and radiographic parameters of patients in the 2 groups were compared with a nonrandomized cohort method. Patients were followed up from 3 to 40 months after surgery according to survival time. Results In group I, the surgery had a mean blood loss of 650 mL and a survival time of 19.1 months. In group II, the surgery had a mean blood loss of 2100 mL and a survival time of 14.14 months. A significant difference in blood loss amount (P = 0.002) was observed. Complications, including deep wound infection, durotomy, and uncontrolled bleeding, were observed in both groups. No postoperative cement-induced neurologic deterioration, implant failure occurred. Conclusions Kyphoplasty with short posterior instrumentation is a novel technique that can be performed safely and effectively for the treatment of thoracolumbar metastatic epidural spinal cord compression. Rigid stability, reduced blood loss, and short fixation decrease surgical morbidity of spinal metastasis.

Background To investigate the role of vertebral augmentation in kyphosis reduction, vertebral fracture union, and correction loss after surgical management of thoracolumbar burst fracture. Design Retrospective chart and radiographic review. Setting Level 1 trauma center. Methods The analysis included patients treated between April 2007 and June 2015, who received pedicle-screw-rod distraction and reduction within two days following acute traumatic thoracolumbar burst fracture with a load sharing score >6. Medical records were retrospectively reviewed for data regarding operative details, imaging and laboratory findings, neurological function, and functional outcomes. Intervention Not applicable. Main outcome measures Sagittal index, pain score, loss of correction, and implant failure rate. Results Nineteen patients were enrolled in this study (mean age, 37.2 ± 13 years; age range, 17–62 years; female/male ratio: 10/9). Of the five patients who received only reduction (no augmentation), one underwent revision surgery because of implant failure and pedicle screw backing out. Compared to patients who received only reduction, those who received both reduction and augmentation showed better sagittal alignment after the operation, with better sagittal index immediately postoperatively and during the follow-up (p Conclusions Transpedicular vertebral augmentation with calcium sulfate/phosphate-based bone cement may reinforce thoracolumbar burst fracture stability, partially restore vertebral body height, and reduce pedicle screw bending and movement, thereby preventing early implant failure and late loss of correction, especially in patients with excellent fracture reduction. Level of evidence: Therapeutic level III, retrospective chart review