Minimally invasive pedicle screw fixation combined with percutaneous vertebroplasty in the surgical treatment of thoracolumbar osteoporosis fracture

作者：Gu, Yutong^*; Zhang, Feng; Jiang, Xiaoxing; Jia, Lianshun; McGuire, Robert

来源：Journal of Neurosurgery-Spine, 2013, 18(6): 634-640.

DOI：10.3171/2013.3.SPINE12827

• osteoporosis
• thoracolumbar vertebral fracture
• vertebroplasty
• percutaneous surgery
• pedicle screw fixation
• minimally invasive spinal surgery
• surgical technique

Object. The purpose of this study was to evaluate the feasibility and safety of minimally invasive pedicle screw fixation combined with percutaneous vertebroplasty (PVP) for treating acute thoracolumbar osteoporotic vertebral compression fracture (VCF) and preventing secondary VCF after PVP. @@@ Methods. Twenty patients with a mean age of 73.6 year's (range 65-85 years) who sustained fresh thoracic or lumbar osteoporotic VCFs without neurological deficits underwent minimally invasive pedicle screw fixation combined with PVP. Visual analog scale pain scores were recorded, and the Cobb angles and the central and anterior vertebral body (VB) heights were measured on the lateral radiographs before surgery and immediately, 1 month, 2 months, 3 months, 6 months, 1 year, and 2 years after surgery. @@@ Results. The patients were followed up for an average of 26 months (range 24-30 months) after sugery. The visual analog scale score was found to be significantly decreased; from 7.3 +/- 1.3 before surgery to 1.2 +/- 0.7 immediately after surgery and to 0.7 +/- 0.7 (p < 0.001) at the end of follow-up. The Cobb angle was 17.0 degrees +/- 4.3 degrees before surgery and 6.4 degrees +/- 3.6 degrees immediately after surgery. The central VB height that was 44.5% +/- 7.6% before surgery increased to 74.6% +/- 6.4% of the estimated intact central height immediately after surgery (p <0.001). The anterior VB height increased from 50.7% +/- 7.4% before surgery to 82.5% +/- 6.7% of the estimated intact anterior height immediately after surgery (p <0.001). There were no significant changes in the results obtained over the follow-up time period. There was no occurrence of new fracture in surgically treated or adjacent vertebrae in these patients. @@@ Conclusions. Minimally invasive pedicle screw fixation combined with PVP is a good choice for the treatment of acute thoracolumbar osteoporotic VCF and can prevent the occurrence of new VCFs after PVP.

• 出版日期2013-6
• 单位天津市中医药研究院附属医院; 复旦大学; 中国人民解放军第二军医大学