Surgical techniques for osteoporotic vertebral collapse with delayed neurological deficits: A systematic review

Sheng, Xiaoyong; Ren, Shengxiang

doi:10.1016/j.ijsu.2016.07.050

Cited by 19 publications

(21 citation statements)

References 32 publications

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“…In this study, we evaluated the surgical outcomes for OVF in the lower lumbar spine with neurological deficits. Previous reports revealed that OVF with neurological deficits frequently develop at the thoracolumbar junction area and that there are few patients with OVF in the low lumbar spine 6,11,15,16 . As a result, the surgical outcomes of lumbar OVF were still unknown.…”

Section: Discussionmentioning

confidence: 99%

“…Most of these studies are case series at a single or small group of institutions, and studies with large sample sizes are scarce. There is one previous large-scale systematic review of 29 papers that included 596 OVF patients with delayed neurological deficits 16 . However, the majority of patients (93.8%) in that review had OVF at the thoracolumbar region (T10-L2).…”

Section: Introductionmentioning

confidence: 99%

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The Surgical Outcomes of Spinal Fusion for Osteoporotic Vertebral Fractures in the Lower Lumbar Spine with a Neurological Deficit

Isogai

Hosogane

Funao

et al. 2020

Spine Surg Relat Res

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Surgical Outcomes of Spinal Fusion for Osteoporotic Vertebral Fractures in the Lower Lumbar Spine with a Neurological Deficit

Isogai

Hosogane

Funao

et al. 2020

Spine Surg Relat Res

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“…Vertebral body collapse, kyphosis, persistent back pain, or disability might occur after vertebral fractures if not treated adequately. 18 , 19 Though the management of thoracolumbar fracture remains a matter of discussion, 20 many surgeons advocate surgical treatment, especially for unstable fractures or neurologically compromised patients. 18 , 19 , 21 Surgical procedures have included decompression, anterior or posterior fixation, or both, with or without fusion.…”

Section: Discussionmentioning

confidence: 99%

Short-segment decompression and fixation for thoracolumbar osteoporotic fractures with neurological deficits

et al. 2018

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ObjectiveWe assessed our results of short-segment decompression and fixation for osteoporotic thoracolumbar fractures with neurological deficits.MethodsWe evaluated 20 elderly patients (age, 60–89 years; mean, 73.2 years) with osteoporotic thoracolumbar fractures and neurological deficits. They underwent short-segment decompression and fixation and followed up for 40.6 (range, 24–68) months. A visual analog scale (VAS) and the Oswestry Disability Index (ODI) were used to measure back pain and disability. We also analyzed patients’ radiologic findings and neurological status. Perioperative and postoperative complications were recorded.ResultsAt the latest follow-up, the average VAS score for back pain and ODI scores had significantly improved. The radiologic assessment showed significant improvements in local kyphosis, anterior vertebral height, and the vertebral wedge angle compared with the original measures. Neurological function also improved in 18 of 20 patients. No major complications occurred perioperatively. Our techniques included preservation of the posterior ligament complex, decortication of facet joints for fusion, no tapping to increase the screw insertional torque, pre-contouring of the rods according to the “adaptive” curve obtained from postural reduction, and postoperative spinal bracing.ConclusionsPosterior short-segment decompression and fixation could be an effective surgical option for osteoporotic thoracolumbar burst fractures with neurological deficits.

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“…There are several studies from other countries such as China, France or Korea; however, the number of patients in their samples were small and studies with a large number of patients is limited [15][16][17] . There is one previous, large-scale, systematic review that included 596 OVF patients with delayed neurological deficit from 29 publications 9) . In this review, posterior surgery was conducted in 60.6% of patients followed by anterior decompression and reconstruction in 36.6%.…”

Section: Discussionmentioning

confidence: 99%

“…Many of these studies are case series at a single institution, or cohort studies from a few institutions; studies with a large sample size are limited. There is one systematic review that included 596 patients from 29 publications comparing three different surgical methods: anterior decompression and reconstruction, posterior surgery, and posteroanterior surgery 9) . However, inclusion criteria may vary among the studies, so it is difficult to perform statistical analysis comparing each surgical pro-cedure, or on various radiological parameters, as the data from each individual patient was not available in this systematic review.…”

Section: Introductionmentioning

confidence: 99%

Surgical Treatment of Osteoporotic Vertebral Fracture with Neurological Deficit-A Nationwide Multicenter Study in Japan-

Hosogane

Nojiri

Suzuki

et al. 2019

Spine Surg Relat Res

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Introduction The prevalence of patients with osteoporosis continues to increase in aging societies, including Japan. The first choice for managing osteoporotic vertebral compression fracture (OVF) is conservative treatment. Failure in conservative treatment for OVF may lead to non-union or vertebral collapse, resulting in neurological deficit and subsequently requiring surgical intervention. This multicenter nationwide study in Japan was conducted to comprehensively understand the outcomes of surgical treatments for OVF non-union. Methods This multicenter, retrospective study included 403 patients (89 males, 314 females, mean age 73.8 ± 7.8 years, mean follow-up 3.9 ± 1.7 years) with neurological deficit due to vertebral collapse or non-union after OVF at T10-L5 who underwent fusion surgery with a minimum 1-year follow-up. Radiological and clinical outcomes at baseline and at the final follow-up (FU) were evaluated. Results OVF was present at a thoracolumbar junction such as T12 (124 patients) and L1 (117 patients). A majority of OVF occurred after a minor trauma, such as falling down (55.3%) or lifting objects (8.4%). Short segment fusion, including affected vertebra, was conducted (mean 4.0 ± 2.0 vertebrae) with 256.8 minutes of surgery and 676.1 g of blood loss. A posterior approach was employed in 86.6% of the patients, followed by a combined anterior and posterior (8.7%), and an anterior (4.7%) approach. Perioperative complications and implant failures were observed in 18.1% and 41.2%, respectively. VAS scores of low back pain (74.7 to 30.8 mm) and leg pain (56.8 to 20.7 mm) improved significantly at FU. Preoperatively, 52.6% of the patients were unable to walk and the rate of non-ambulatory patients decreased to 7.5% at FU. Conclusions This study demonstrated that substantial improvement in activity of daily living (ADL) was achieved by fusion surgery. Although there was a considerable rate of complications, fusion surgery is beneficial for elderly OVF patients with non-union.

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Surgical techniques for osteoporotic vertebral collapse with delayed neurological deficits: A systematic review

Cited by 19 publications

References 32 publications

The Surgical Outcomes of Spinal Fusion for Osteoporotic Vertebral Fractures in the Lower Lumbar Spine with a Neurological Deficit

The Surgical Outcomes of Spinal Fusion for Osteoporotic Vertebral Fractures in the Lower Lumbar Spine with a Neurological Deficit

Short-segment decompression and fixation for thoracolumbar osteoporotic fractures with neurological deficits

Surgical Treatment of Osteoporotic Vertebral Fracture with Neurological Deficit-A Nationwide Multicenter Study in Japan-

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