2024-03-29T15:55:43Z
https://nagoya.repo.nii.ac.jp/oai
oai:nagoya.repo.nii.ac.jp:00018432
2023-11-16T05:20:27Z
499:508:509:1637
COMBINED POSTERIOR-ANTERIOR SURGERY FOR OSTEOPOROTIC DELAYED VERTEBRAL FRACTURE WITH NEUROLOGIC DEFICIT
NAKASHIMA, HIROAKI
53560
YUKAWA, YASUTSUGU
53561
ITO, KEIGO
53562
MACHINO, MASAAKI
53563
ISHIGURO, NAOKI
53564
KATO, FUMIHIKO
53565
osteoporotic vertebral fracture
combined posterior-anterior spine surgery
thoracolumbar spine
spinal instrumentation
2014-08
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 ASIA impairment scale, and 74% demonstrated an improvement in ADL status. No deterioration was observed in neurological or ADL status after surgery. With regard to sagittal alignment, preoperative kyphosis of 18.4 degrees was corrected to 2.4 degrees of kyphosis postoperatively. However, 11.5 degrees loss of correction was observed at final follow-up observation. Combined posterior-anterior surgery could provide reliable improvement in both neurological and ADL status, although maintenance of postoperative alignment was difficult to achieve in some cases.
departmental bulletin paper
Nagoya University School of Medicine
2014-08
Nagoya Journal of Medical Science
3-4
76
307
314
http://hdl.handle.net/2237/20549
2186-3326
0027-7622
eng
http://www.med.nagoya-u.ac.jp/medlib/nagoya_j_med_sci/7634/7634.html