Short- versus long-segment posterior spinal fusion with vertebroplasty for osteoporotic vertebral collapse with neurological impairment in thoracolumbar spine: a multicenter study

BMC Musculoskeletal Disorders

Michio Hongo¹  Seiji Ohtori²  Sumihisa Orita²  Takeo Furuya²  Yasuchika Aoki³  Kazuyoshi Nakanishi⁴  Masahiko Takahata⁵  Akira Iwata⁵  Hirooki Endo⁶  Hirokazu Inoue⁷  Atsushi Kimura⁷  Katsuhito Yoshioka⁸  Haruki Funao⁹  Ken Ishii⁹  Naobumi Hosogane⁹  Norihiro Isogai⁹  Kenya Nojiri⁹  Eijiro Okada⁹  Kota Watanabe⁹  Seiji Ueda⁹  Yuta Shiono⁹  Tomohiro Hikata⁹  Satoshi Suzuki⁹  Masayuki Miyagi^1,10  Gen Inoue^1,10  Wataru Saito^1,10  Takashi Yurube^1,11  Kenichiro Kakutani^1,11  Katsuhito Kiyasu^1,12  Nobuhiko Yokoyama^1,13  Hidekazu Oishi^1,13  Katsumi Harimaya^1,13  Kenichi Kawaguchi^1,13  Toshiro Doi^1,13  Atsushi Tagami^1,14  Shuta Yamada^1,14  Shinji Adachi^1,14  Hideki Murakami^1,15  Kazuyoshi Kobayashi^1,16  Kei Ando^1,16  Shiro Imagama^1,16  Masashi Oshima^1,17  Yohei Shibuya^1,18  Tomohiro Izumi^1,18  Yuya Ishikawa^1,18  Naoto Endo^1,18  Masayuki Ohashi^1,18  Kei Watanabe^1,18  Toru Hirano^1,18  Keiichi Katsumi^1,18  Hidetomi Terai^1,19  Koji Tamai^1,19  Atsushi Nakano^2,20  Takashi Kaito^2,21  Hiroyasu Fujiwara^2,21  Tomoya Yamashita^2,21  Yukitaka Nagamoto^2,21  Masayuki Shimizu^2,22  Toshimasa Futatsugi^2,22  Shota Ikegami^2,22  Daisuke Sakai^2,23  Tadashi Nukaga^2,23  Hirosuke Nishimura^2,24  Hidekazu Suzuki^2,24  Yuji Matsuoka^2,24  Shuta Ushio^2,25  Toshitaka Yoshii^2,25  Shoji Seki^2,26  Toshinori Tsukanishi^2,27  Tetsuya Abe^2,27 

[1] Department of Orthopaedic Surgery, Akita University;Department of Orthopaedic Surgery, Chiba University;Department of Orthopaedic Surgery, Eastern Chiba Medical Center;Department of Orthopaedic Surgery, Hiroshima University;Department of Orthopaedic Surgery, Hokkaido University;Department of Orthopaedic Surgery, Iwate Medical University;Department of Orthopaedic Surgery, Jichi Medical University;Department of Orthopaedic Surgery, Kanazawa University;Department of Orthopaedic Surgery, Keio University School of Medicine;Department of Orthopaedic Surgery, Kitasato University;Department of Orthopaedic Surgery, Kobe University;Department of Orthopaedic Surgery, Kochi University;Department of Orthopaedic Surgery, Kyushu University;Department of Orthopaedic Surgery, Nagasaki University;Department of Orthopaedic Surgery, Nagoya City University;Department of Orthopaedic Surgery, Nagoya University;Department of Orthopaedic Surgery, Nihon University Itabashi Hospital;Department of Orthopaedic Surgery, Niigata University;Department of Orthopaedic Surgery, Osaka City University;Department of Orthopaedic Surgery, Osaka Medical College;Department of Orthopaedic Surgery, Osaka University;Department of Orthopaedic Surgery, Shinshu University;Department of Orthopaedic Surgery, Tokai University;Department of Orthopaedic Surgery, Tokyo Medical University;Department of Orthopaedic Surgery, Tokyo Medical and Dental University;Department of Orthopaedic Surgery, University of Toyama;Department of Orthopaedic Surgery, University of Tsukuba;

关键词: Osteoporotic vertebral collapse;    Vertebral fracture;    Thoracolumbar spine;    Vertebroplasty;    Posterior spinal fusion;    Short-segment;   

DOI  :  10.1186/s12891-020-03539-0

来源: DOAJ

【 摘 要 】

Abstract Background Vertebroplasty with posterior spinal fusion (VP + PSF) is one of the most widely accepted surgical techniques for treating osteoporotic vertebral collapse (OVC). Nevertheless, the effect of the extent of fusion on surgical outcomes remains to be established. This study aimed to evaluate the surgical outcomes of short- versus long-segment VP + PSF for OVC with neurological impairment in thoracolumbar spine. Methods We retrospectively collected data from 133 patients (median age, 77 years; 42 men and 91 women) from 27 university hospitals and their affiliated hospitals. We divided patients into two groups: a short-segment fusion group (S group) with 2- or 3-segment fusion (87 patients) and a long-segment fusion group (L group) with 4- through 6-segment fusion (46 patients). Surgical invasion, clinical outcomes, local kyphosis angle (LKA), and complications were evaluated. Results No significant differences between the two groups were observed in terms of neurological recovery, pain scale scores, and complications. Surgical time was shorter and blood loss was less in the S group, whereas LKA at the final follow-up and correction loss were superior in the L group. Conclusion Although less invasiveness and validity of pain and neurological relief are secured by short-segment VP + PSF, surgeons should be cautious regarding correction loss.

【 授权许可】

Unknown