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Surgical options for symptomatic old osteoporotic vertebral compression fractures: A retrospective study of 238 cases
- Source :
- BMC Surgery, Vol 21, Iss 1, Pp 1-10 (2021), BMC Surgery
- Publication Year :
- 2020
- Publisher :
- Research Square Platform LLC, 2020.
-
Abstract
- Background Symptomatic osteoporotic vertebral compression fractures (OVCF) are increasing, as are acute and chronic pain episodes and progressive spinal deformities. However, there are no clear surgical treatment criteria for patients with these different symptoms. Therefore, this study aims to explore the surgical approaches for the treatment of OVCF with different symptoms and evaluate the feasibility of these surgical approaches. Methods We retrospectively analyzed 238 symptomatic OVCF patients who entered our hospital from June 2013 to 2016. According to clinical characteristics and imaging examinations, these patients were divided into I-V grades and their corresponding surgical methods were developed. I, old vertebral fracture with no apparent instability, vertebral augmentation; II, old vertebral fracture with local instability, posterior reduction fusion internal fixation; III, old fractures with spinal stenosis, posterior decompression and reduction fusion and internal fixation; IV, old vertebral fracture with kyphosis, posterior osteotomy with internal fixation and fusion; V, a mixture of the above types, posterior osteotomy (decompression) with internal fixation and fusion. Postoperative visual analog score (VAS), oswestry disability index (ODI) scores, sagittal index (SI) and ASIA grades of neurological function were observed. Results All 238 patients were followed up for 12–38 months, with an average follow-up of 18.5 months. After graded surgery, the VAS score, ODI score, and vertebral sagittal index SI of 238 patients were significantly improved, and the difference between the last follow-up results and the preoperative comparison was statistically significant (P ˂ 0.05). Besides, the postoperative ASIA grades of 16 patients with nerve injury were improved from 14 patients with preoperative grade C, 2 patients with grade D to 4 patients with postoperative grade D and 12 patients with postoperative grade E. Conclusion In this study, we concluded that graded surgery could better treat symptomatic old OVCF and restore spinal stability. This provides clinical reference and guidance for the treatment of symptomatic old OVCF in the future.
- Subjects :
- medicine.medical_specialty
Visual analogue scale
Decompression
Spinal stenosis
medicine.medical_treatment
lcsh:Surgery
Kyphosis
Osteotomy
Sagittal index
Fracture Fixation, Internal
03 medical and health sciences
0302 clinical medicine
Graded surgery
Visual analog score
Fractures, Compression
Humans
Medicine
Internal fixation
030212 general & internal medicine
Oswestry disability index
Retrospective Studies
Symptomatic old osteoporotic vertebral compression fractures
Lumbar Vertebrae
business.industry
lcsh:RD1-811
General Medicine
medicine.disease
Sagittal plane
Surgery
Oswestry Disability Index
Treatment Outcome
medicine.anatomical_structure
Spinal Fractures
business
Osteoporotic Fractures
030217 neurology & neurosurgery
Research Article
Subjects
Details
- Database :
- OpenAIRE
- Journal :
- BMC Surgery, Vol 21, Iss 1, Pp 1-10 (2021), BMC Surgery
- Accession number :
- edsair.doi.dedup.....b770cfc5018cce61c4ad5c2366bc369e
- Full Text :
- https://doi.org/10.21203/rs.3.rs-55436/v2