Effectiveness of posterior single-level osteotomy with 360° release and correction in treatment of osteoporotic vertebral compression fractures with moderate to severe kyphosis.
10.7507/1002-1892.202509073
- Author:
Peidong QING
1
;
Hongda XU
1
;
Youpeng HU
1
;
Bin XIE
1
;
Tieheng WANG
1
;
Lei ZHANG
1
Author Information
1. Department of Spinal Surgery, Mianyang Orthopedic Hospital, Mianyang Sichuan, 621000, P. R. China.
- Publication Type:Journal Article
- Keywords:
Cage;
Osteoporotic vertebral compression fractures;
intervertebral osteotomy;
moderate to severe kyphosis
- MeSH:
Humans;
Kyphosis/etiology*;
Male;
Female;
Osteotomy/methods*;
Middle Aged;
Retrospective Studies;
Aged;
Spinal Fractures/diagnostic imaging*;
Fractures, Compression/diagnostic imaging*;
Osteoporotic Fractures/complications*;
Treatment Outcome;
Lumbar Vertebrae/injuries*;
Thoracic Vertebrae/injuries*;
Operative Time;
Fracture Fixation, Internal/methods*
- From:
Chinese Journal of Reparative and Reconstructive Surgery
2025;39(12):1574-1579
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To explore the effectiveness of posterior single-level osteotomy with 360° release and correction for the treatment of osteoporotic vertebral compression fractures (OVCF) complicated with moderate to severe kyphosis.
METHODS:A retrospective analysis was conducted on 11 patients with OVCF complicated with moderate to severe kyphosis between January 2022 and March 2023. There were 4 males and 7 females with an average age of 57 years ranging from 47 to 69 years. The disease duration ranged from 3 to 15 months, with an average of 7 months. Fracture segments included T 11 in 3 cases, T 12 in 5, L 1 in 2, and L 2 in 1. The T value of lumbar spine bone density was -5.0 to -2.0, with an average of -3.5. The preoperative neurological function was grade E according to Frankel grading. The Pfirrmann classification of the intervertebral disc above the injured vertebra was grade Ⅲ in 8 cases and grade Ⅳ in 3 cases. All patients underwent posterior single-level osteotomy with 360° release and correction. The operation time, intraoperative blood loss, hospital stay, and postoperative complications were recorded. Thoracolumbar local kyphosis Cobb angle, the mean height of the functional spinal unit (FSU), the sagittal vertical axis (SVA), and the sagittal index (SI) were measured. The visual analogue scale (VAS) score and Oswestry disability index (ODI) were used to evaluate the improvement of pain and function before operation, at 1 month after operation, and at last follow-up.
RESULTS:The operation successfully completed in all patients, and there was no obvious complication. The operation time ranged from 100 to 190 minutes, with an average of 153 minutes, and the intraoperative blood loss ranged from 200 to 800 mL, with an average of 468 mL. The length of hospital stay was 8-14 days (mean, 12 days). All patients were followed up 6-24 months, with an average of 12.4 months. At last follow-up, all the 11 patients had bony fusion in the osteotomy area, and there was no displacement or subsidence of the Cage, no complication such as internal fixation failure or pseudarthrosis formation was found. The Cobb angle of local thoracolumbar kyphosis, the mean height of FSU, SVA, and SI significantly improved immediately after operation and at last follow-up when compared with preoperative ones, and the VAS score and ODI also significantly improved at 1 month after operation and at last follow-up ( P<0.05); there was no significant difference in above indexes between the two time points after operation ( P>0.05).
CONCLUSION:Posterior single-level osteotomy with 360° release and correction is an effective surgical method for treating OVCF complicated with moderate to severe kyphosis, with definite early effectiveness.
