Posterior dynamic stabilization in addition to kyphoplasty for surgical management of unstable osteoporotic vertebral compression fractures.

PURPOSE

This study aimed to evaluate the radiological and clinical outcomes of combining kyphoplasty (KP) with posterior dynamic stabilization (PDS) in patients with vertebral compression fractures (VCFs) over a 1-year follow-up period.

METHODS

A retrospective analysis was conducted on 40 patients who underwent KP and PDS procedures between 2006 and 2023. The cohort consisted of 16 men and 24 women, with a mean age of 71.32 ± 12.14 years (range, 61-89). Fractures were categorized using both the Arbeitsgemeinschaft für Osteosynthesefragen (AO) thoracolumbar classification and the Osteoporotic Fracture (OF) classification systems. Radiographic measurements included vertebral kyphosis angle (VKA), local kyphosis angle (LKA), and percentage of vertebral collapse (PVC). Clinical outcomes were assessed using Visual Analog Scale (VAS) scores recorded preoperatively, at 3 months postoperatively, and at 1-year follow-up. These data points were then compared.

RESULTS

Significant reductions in VKA and LKA were observed in the early postoperative period, at 3 months, and at 1 year compared to preoperative measurements (p < 0.05) However, changes in VKA between the early postoperative period and subsequent follow-ups at 3 months and 1 year were not statistically significant (p > 0.05). PVC and VAS scores also showed significant improvement at all postoperative time points compared to baseline (p < 0.05).

CONCLUSIONS

The significant postoperative improvements in LKA, VKA, PVC, and VAS scores, along with the low incidence of fracture progression or new fractures, suggest that KP supplemented with PDS yields favorable radiological and clinical outcomes in patients with unstable osteoporotic VCFs.