Masuda Soichiro, Onishi Eijiro, Ota Satoshi, Fujita Satoshi, Sueyoshi Tatsuya, Hashimura Takumi, Yasuda Tadashi
Department of Orthopedic Surgery, Kobe City Medical Center General Hospital, Hyogo, Japan.
Spine Surg Relat Res. 2018 Jan 25;3(3):249-254. doi: 10.22603/ssrr.2018-0102. eCollection 2019.
In general, osteoporotic vertebral fractures with neurological deficits require surgery. However, the ideal surgical method remains controversial. We evaluated the efficacy of combining posterior instrumented fusion and vertebroplasty using allograft bone chips.
Twelve patients (five men, seven women; age 68-84 years, mean age 75.9 years) with osteoporotic vertebral fractures with neurological deficits were reviewed retrospectively. They underwent posterior instrumented fusion and vertebroplasty, using allograft bone, at our institution between January 2007 and June 2016. We assessed the surgical results, radiologically and neurologically, after a mean follow-up of 37.3 months.
The mean local kyphosis angle was 10° before surgery, -3.3° immediately after surgery, and 4.4° at follow-up. The average spinal canal compromise was 26.9% before surgery and 19.5% at follow-up. All patients achieved bony fusion and none needed additional surgery. All patients improved by at least one grade on the modified Frankel grading system.
Combining vertebroplasty, using allograft bone chips, and posterior instrumented fusion appears to be an effective option for osteoporotic vertebral fractures with neurological deficits.
一般来说，伴有神经功能缺损的骨质疏松性椎体骨折需要手术治疗。然而，理想的手术方法仍存在争议。我们评估了使用同种异体骨碎片联合后路器械融合和椎体成形术的疗效。
回顾性分析了12例伴有神经功能缺损的骨质疏松性椎体骨折患者（5例男性，7例女性；年龄68 - 84岁，平均年龄75.9岁）。2007年1月至2016年6月期间，他们在我们机构接受了使用同种异体骨的后路器械融合和椎体成形术。平均随访37.3个月后，我们从影像学和神经学方面评估了手术结果。
术前平均局部后凸角为10°，术后即刻为-3.3°，随访时为4.4°。术前平均椎管狭窄率为26.9%，随访时为19.5%。所有患者均实现了骨融合，无一例需要再次手术。所有患者在改良Frankel分级系统中至少提高了一个等级。
对于伴有神经功能缺损的骨质疏松性椎体骨折，使用同种异体骨碎片的椎体成形术联合后路器械融合似乎是一种有效的选择。
