Treatment of Kyphosis After Vertebroplasty with Limited Osteotomy and Short-Segment Fixation and Fusion

Zhang Tingwei; Yu Peng; Liu Bin; Yang Kai; Bi Xiaoyuan; Jiang Zewei; Li Jiajia; Zhou Jiping

Abstract：Objective To investigate the clinical efficacy of limited osteotomy combined with short-segment fixation and fusion in the treatment of kyphotic deformity that arises after vertebroplasty with pedicle screw fixation.Methods A total of 53 patients with kyphosis and severe back pain following vertebroplasty were enrolled at Wendeng Osteopathic Hospital of Shandong Province from January 2019 to February 2023.The cohort included 17 males and 36 females,aged 60 to 71 years,with a mean age of(67.25±7.18)years.All patients underwent posterior limited spinal osteotomy,short-segment fixation,and fusion surgery.The operation time,intraoperative blood loss,postoperative incision drainage,neurological function recovery,and complication rate were recorded.Additionally,the visual analogue score(VAS),Oswestry disability index(ODI),and kyphotic segmental Cobb angle were documented preoperatively,2 weeks postoperatively,and at the final follow-up.Results All 53 patients completed follow-up,with a mean follow-up duration of(16.25±4.64)months.The mean operation time was(125.21±66.44)minutes,intraoperative blood loss was(550.51±100.32)mL,and postoperative drainage was(245.35±56.37)mL.Statistically significant differences were observed in VAS score,ODI index,and kyphotic Cobb angle at both 2 weeks and the final follow-up(P＜0.01).At the final follow-up,the Cobb angle of the fused segment increased slightly compared to 2 weeks postoperatively,but this difference was not statistically significant(P＞0.05).During surgery,two cases of dural sac rupture occurred,which were promptly sutured and covered with artificial dura membrane,preventing cerebrospinal fluid leakage postoperatively.At the final follow-up,the osteotomy site was satisfactorily fused,and no screw loosening or fracture was observed in any case.Conclusion Limited osteotomy combined with short-segment fixation and fusion is a safe and effective treatment for kyphosis that develops after vertebroplasty.It significantly reduces pain,improves spinal functionality,and corrects kyphotic deformity.