Clinical and Radiologic Features of Osteoporotic Spine Fracture with Delayed Neurologic Compromises

Park, Hyung-Youl; Ahn, Jin-Hwan; Ha, Kee-Yong; Kim, Young-Hoon; Kim, Sang Il; Min, Hyung-Ki; Oh, In-Soo; Seo, Jun-Yeong; Park, Seong-Hyeon

doi:10.1016/j.wneu.2018.09.056

Cited by 14 publications

(14 citation statements)

References 20 publications

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“…As expected, the patient's lower back pain was signi cantly relieved, and 10 patients with signi cant nerve injury had a signi cant improvement in postoperative AISA grade. Our results are also consistent with previous reports [3,19]. Part IV patients had local instability of the vertebral body, and the biomechanics of the spine was destroyed.…”

Section: Discussionsupporting

confidence: 93%

“…Due to OVCF is a kind of low-energy damage, and the patient is slow to respond to pain at the old age, which fails to attract enough attention, often leading to delay in the disease, missing the best treatment opportunity, and nally the fracture is changed from a fresh fracture to an old fracture. The most common ones are changes in osteonecrosis, and even kyphosis and nerve compression [3], which seriously affects the quality of life of patients and delays the treatment effect [4].…”

Section: Introductionmentioning

confidence: 99%

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Selection of surgical treatment approaches for old osteoporotic vertebral compression fractures: A Retrospective Study of 238 Cases

Zhou

Hao

Dong

et al. 2020

Preprint

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Background As the population ages, osteoporotic vertebral compression fractures (OVCF) are increasing, as are acute and chronic pain episodes and progressive spinal deformities. Therefore, the aim of our study was to investigate the treatment of symptomatic old osteoporotic vertebral compression fractures. Methods A retrospective study was designed to enroll patients with symptomatic old OVCFs from June 2013 to 2016. According to the complexity of the disease, the patients were divided into I to V grades, and the surgical methods were developed according to the grades. Postoperative visual analog score (VAS), oswestry disability index (ODI) scores, sagittal index (SI) and ASIA grades of neurological function were observed. Results VAS score, ODI score and SI of all patients were significantly improved as compared with that before surgery, and the results of the final follow-up were statistically significant in comparison to preoperative outcome (P˂0.05). All the 16 patients with nerve injury showed significant improvement after surgery. The AISA grade were improved from grade C (14 cases), grade D (2 case) to grade D (4 cases) and grade E (12 cases). Conclusion Old OVCFs are difficult to treat. Graded surgery can better restore spinal stability and improve clinical outcomes.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Selection of surgical treatment approaches for old osteoporotic vertebral compression fractures: A Retrospective Study of 238 Cases

Zhou

Hao

Dong

et al. 2020

Preprint

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“…[12][13][14][15] Two of these identified posterior wall involvement as a risk factor. 13,14 Additionally, initial height loss, midportion type fractures, swelled front type as well as dented type fractures in accordance with Sugita et al (Figure 2), complex fracture morphology, development of an intravertebral cleft, fracture instability, fractures at the thoracolumbar junction, and specific MRI changes that will be mentioned later in the text were listed [12][13][14][15][16] Another investigation looked at risk factors for vertebral collapse and spinal canal compromise resulting in neurologic symptoms. 17 They concluded that posterior vertebral body height loss, fracture involvement of both endplates and specific MRI changes conferred higher risk.…”

Section: Fracture-specific Risk Factorsmentioning

confidence: 99%

“…11,16 Risk factors were the following: bow-shaped type fractures, Fracture types with high rates of failure. [11][12][13][14][15][16][17][18][19] projecting type fractures and swelled front type fractures (Figure 2). Hoshino et al defined poor outcomes either as low physical component scores (SF 36), a low level of independence or high pain levels.…”

Section: Fracture-specific Risk Factorsmentioning

confidence: 99%

Risk Factors for Failure in Conservatively Treated Osteoporotic Vertebral Fractures: A Systematic Review

Scheyerer

Spiegl

Grueninger

et al. 2021

Global Spine Journal

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Study Design: Systematic review. Objectives: Osteoporosis is one of the most common diseases of the elderly, whereby vertebral body fractures are in many cases the first manifestation. Even today, the consequences for patients are underestimated. Therefore, early identification of therapy failures is essential. In this context, the aim of the present systematic review was to evaluate the current literature with respect to clinical and radiographic findings that might predict treatment failure. Methods: We conducted a comprehensive, systematic review of the literature according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) checklist and algorithm. Results: After the literature search, 724 potentially eligible investigations were identified. In total, 24 studies with 3044 participants and a mean follow-up of 11 months (range 6-27.5 months) were included. Patient-specific risk factors were age >73 years, bone mineral density with a t-score <−2.95, BMI >23 and a modified frailty index >2.5. The following radiological and fracture-specific risk factors could be identified: involvement of the posterior wall, initial height loss, midportion type fracture, development of an intravertebral cleft, fracture at the thoracolumbar junction, fracture involvement of both endplates, different morphological types of fractures, and specific MRI findings. Further, a correlation between sagittal spinal imbalance and treatment failure could be demonstrated. Conclusion: In conclusion, this systematic review identified various factors that predict treatment failure in conservatively treated osteoporotic fractures. In these cases, additional treatment options and surgical treatment strategies should be considered in addition to follow-up examinations.

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“…The purpose of surgery was to relieve nerve compression and restore spinal stability. Previous, Park et al depicted that this surgery was effective in relieving delayed neurologic compromises [19]. Besides, Lee et al had shown that posterior decompression and reduction fusion and internal xation can relieve spinal cord compression and nerve compression [20].…”

Section: Posterior Decompression and Reduction Fusion And Internal Xamentioning

confidence: 99%

Surgical options for symptomatic old osteoporotic vertebral compression fractures: A retrospective study of 238 cases

Zhou

Hao

Dong

et al. 2020

Preprint

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Background: Symptomatic osteoporotic vertebral compression fractures (OVCF) are increasing, as are acute and chronic pain episodes and progressive spinal deformities. However, there are no clear surgical treatment criteria for patients with these different symptoms. Therefore, this study aims to explore the surgical approaches for the treatment of OVCF with different symptoms and evaluate the feasibility of these surgical approaches.Methods: We retrospectively analyzed 238 symptomatic OVCF patients who entered our hospital from June 2013 to 2016. According to clinical characteristics and imaging examinations, these patients were divided into I-V grades and their corresponding surgical methods were developed. I, old vertebral fracture with no apparent instability, vertebral augmentation; II, old vertebral fracture with local instability, posterior reduction fusion internal fixation; III, old fractures with spinal stenosis, posterior decompression and reduction fusion and internal fixation; IV, old vertebral fracture with kyphosis, posterior osteotomy with internal fixation and fusion; V, a mixture of the above types, posterior osteotomy (decompression) with internal fixation and fusion. Postoperative visual analog score (VAS), oswestry disability index (ODI) scores, sagittal index (SI) and ASIA grades of neurological function were observed.Results: All 238 patients were followed up for 12-38 months, with an average follow-up of 18.5 months. After graded surgery, the VAS score, ODI score, and vertebral sagittal index SI of 238 patients were significantly improved, and the difference between the last follow-up results and the preoperative comparison was statistically significant (P˂0.05). Besides, the postoperative ASIA grades of 16 patients with nerve injury were improved from 14 patients with preoperative grade C, 2 patients with grade D to 4 patients with postoperative grade D and 12 patients with postoperative grade E.Conclusion: In this study, we concluded that graded surgery could better treat symptomatic old OVCF and restore spinal stability. This provides clinical reference and guidance for the treatment of symptomatic old OVCF in the future.

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Clinical and Radiologic Features of Osteoporotic Spine Fracture with Delayed Neurologic Compromises

Cited by 14 publications

References 20 publications

Selection of surgical treatment approaches for old osteoporotic vertebral compression fractures: A Retrospective Study of 238 Cases

Selection of surgical treatment approaches for old osteoporotic vertebral compression fractures: A Retrospective Study of 238 Cases

Risk Factors for Failure in Conservatively Treated Osteoporotic Vertebral Fractures: A Systematic Review

Surgical options for symptomatic old osteoporotic vertebral compression fractures: A retrospective study of 238 cases

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