Effect of Posterior Approach and Anterior Approach Internal Fixation Fusion on Senile Osteoporotic Spinal Fracture

DAI Lei

doi:10.3969/j.issn.1004-437X.2025.03.014

Abstract：Objective To investigate the effects of different approaches of internal fixation and fusion in the treatment of senile osteoporotic spinal fractures.Methods A total of 107 elderly patients with osteoporotic spinal fracture treated in the First Affiliated Hospital of Zhengzhou University from April 2021 to April 2023 were divided into posterior approach group(55 cases)and anterior approach group(52 cases)according to approaches.Posterior approach group underwent posterior approach internal fixation fusion,and anterior approach group underwent anterior approach internal fixation fusion.The surgical indexes,spinal function before and after surgery,bone metabolism indexes[bone gla protein(BGP),procollagen ⅠN-terminal propeptide(PⅠ CP),osteoprotegerin(OPG)],postoperative spinal nerve function,pain degree and complications were compared between the two groups.Results Compared with the anterior approach group,the posterior approach group had less bleeding,shorter operative time,shorter hospitalization time,and shorter wound healing time(P＜0.05).Postoperative pain scores and spinal function scores in the posterior approach group were lower than those in the anterior approach group(P＜0.05).The levels of serum BGP,P Ⅰ CP and OPG in the approach group were higher than those in the former approach group 3 months after operation(P＜0.05).Three months after surgery,there was no significant difference in spinal nerve function between the two groups(P＞0.05).There was no significant difference in the incidence of complications between the two groups(1.82％vs 7.69％)(P＞0.05).Conclusion Posterior internal fixation and fusion in elderly patients with osteoporotic spinal fracture can promote rapid recovery of spinal function,improve bone metabolism index,reduce postoperative pain and accelerate rehabilitation process.