Comparison of Percutaneous Kyphoplasty With or Without Posterior Pedicle Screw Fixation on Spinal Sagittal Balance in Elderly Patients With Severe Osteoporotic Vertebral Compression Fracture: A Retrospective Study

Frontiers in Surgery

article

Quan Zhou¹  Lei Deng¹  Xinfeng Zhou¹  Huilin Yang¹  Tao Liu¹ 

[1] Department of Orthopaedics, The First Affiliated Hospital of Soochow University

关键词: osteoporosis;    vertebral compression fracture;    percutaneous kyphoplasty;    posterior pedicle screw fixation;    spinal sagittal balance;   

DOI  :  10.3389/fsurg.2022.800664

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Objective To compare the effects of percutaneous kyphoplasty (PKP) with or without posterior pedicle screw fixation (PPSF) on spinal sagittal balance in elderly patients with severe osteoporotic vertebral compression fracture (sOVCF). Methods From January 2016 to December 2018, 102 elderly patients with single-level thoracolumbar sOVCF were enrolled. Among them, 78 cases underwent PKP (Group A), and 24 cases underwent PPSF+KP (Group B). Clinical evaluation included perioperative parameters, Oswestry Disability Index (ODI) and Visual Analog Scale (VAS) for back pain; Radiographic evaluation included anterior vertebral height (AVH) and rate (AVHr), local kyphotic angle (LKA), and spino-pelvic sagittal balance parameters. Results Perioperative parameters including operation time, blood loss, fluoroscopic time and hospital stay in Group A were less than those in Group B ( p 0.05), other radiographic parameters of both groups were improved significantly in the three follow-ups after surgery ( p < 0.05). The AVH, AVHr, LKA and lumbar lordosis (LL) in Group B were better than those in Group A in the three follow-ups after surgery ( p < 0.05). At the final follow-up, the sacral slope (SS) and pelvic tilt (PT) differed significantly between the two groups ( p < 0.05). Conclusions Both PPSF+KP and PKP can achieve favorable clinical outcomes and maintain the spinal sagittal balance. Compared with PPSF+KP, PKP showed more significant advantages in the early post-operative period. However, in the long-term follow-up, PPSF+KP showed better clinical outcomes and may be better than PKP in maintaining spinal sagittal balance.

【 授权许可】

CC BY