Vertebroplasty and vertebroplasty in combination with intermediate bilateral pedicle screw fixation for OF4 in osteoporotic vertebral compression fractures: a retrospective single-Centre cohort study

Author:

Zhong Weiyang,Liang Xinjie,Luo Xiaoji,Quan Zhengxue

Abstract

Abstract Background Although various studies have described the outcomes and complications of each treatment for OF 4 in osteoporotic vertebral compression fractures (OVCFs), there is still no consensus on the optimal treatment regimen. This study aimed to investigate the clinical effect of OF 4 in patients with OVCFs treated with percutaneous vertebroplasty (PV) compared with PV in combination with intermediate bilateral pedicle screw fixation (IBPSF). Methods A total of 110 patients with OF 4 in OVCFs from January 2011 to December 2013 were reviewed retrospectively and divided into two groups (group A: PV, group B: PV + IBPSF). According to the guidelines of the German Society for Orthopaedics and Trauma (DGOU), OF 4 consists of 3 fracture types. The clinical and radiographic assessments were observed preoperatively, postoperatively, and during follow-up. Results The patients were followed for an average of 60.50 ± 15.20 months (group A) and 58.20 ± 17.60 months (group B) without significant differences. No significant differences were found in BMD, BMI and cement volume between the two groups, but differences were found for operation time, blood loss, and hospitalization time. The VAS and ODI scores improved better significantly at the final follow-up in group B but not in group A. Compared with the preoperative values, the postoperative kyphosis angle and loss of fractured segment height significantly improved, but the difference between the groups was significant after 3 months postoperatively. The loss of angular correction and fractured segment height in group A were greater than those in group B. A total of 15 cases of cement leakage were observed in group A and 8 cases in group B, and no complications or revision surgeries were observed in either group. Thirteen new fractures occurred (11 in group A and 2 in group B), which was significant. Conclusion PV with IBPSF could provide effective restoration and maintenance of fractured segment height and segment alignment as well as a lower rate of complications of OF 4 in OVCFs.

Publisher

Springer Science and Business Media LLC

Subject

General Medicine,Surgery

Reference20 articles.

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2. Schnake KJ, Hahn P, Franck A, et al. Development of a classification system (OF-classification) and of a score for therapeutic decision making (OF-score) for osteoporotic thoracolumbar fractures. Eur Spine J. 2013;22:2590.

3. Schnake KJ, Blattert TR, Hahn P, et al. Classification of osteoporotic thoracolumbar spine fractures: recommendations of the spine section of the German Society for Orthopaedics and Trauma (DGOU). Global Spine J. 2018 Sep;8(2 Suppl):46S–9S.

4. Blattert TR, Schnake KJ, Gonschorek O, et al. Nonsurgical and surgical Management of Osteoporotic Vertebral Body Fractures: recommendations of the spine section of the German Society for Orthopaedics and Trauma (DGOU). Global Spine J. 2018;8(2 Suppl):50S–5S.

5. Chosa K, Naito A, Awai K. Newly developed compression fractures after percutaneous vertebroplasty: comparison with conservative treatment. Jpn J Radiol. 2011;29:335–41.

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