Ponte Osteotomy Combined with Satellite Rod in the Treatment of Old Osteoporotic Thoracolumbar Fracture with Kyphosis

Ding Ziyi; Zhang Shilei; Shi Quan; Gao Bo; Yan Ming

Abstract：Objective To evaluate the efficacy of Ponte osteotomy combined with satellite rod in the treatment of old osteoporotic thoracolumbar fracture with kyphosis.Methods We retrospectively analyzed the general clinical data of 23 patients with old thoracolumbar fracture complicated by kyphosis who underwent Ponte osteotomy in the Department of Orthopaedics,Xijing Hospital,Air Force Medical University,from January 2016 to December 2018.The cohort included 7 males and 16 females,with an average age of(61.46±7.40)years,ranging from 50 to 71 years.Data collected included age,gender,bone mineral density,fracture segment,and operation-related data such as operation time,blood loss,and postoperative time to ambulation.Follow-up related indicators were also analyzed,including preoperative and last follow-up low back pain VAS scores,ODI scores,Cobb angles of preoperative,postoperative,and last follow-up thoracolumbar kyphosis,and SVA.Results All patients underwent successful operations.The operation time was(171.93±44.83)min,blood loss during operation was(275.19±117.37)mL,and postoperative time to ambulation was(3.23±0.61)days.The follow-up period for all patients ranged from 24 to 40 months,with a mean of(29.36±6.74)months.Moreover,the Cobb angle of thoracolumbar kyphosis and SVA improved significantly after operation and at the last follow-up(P＜0.05),while no significant change in the Cobb angle of thoracolumbar kyphosis and SVA was observed between post-operation and last follow-up(P＞0.05).At the last follow-up,the VAS and ODI scores improved significantly compared to pre-operation(P＜0.05).Conclusion The Ponte osteotomy correction approach combined with satellite rod can achieve satisfactory clinical effects in the treatment of osteoporotic thoracolumbar fracture with kyphosis.It is worth further popularizing due to its benefits such as a small osteotomy range,low difficulty of operation,less trauma during operation,and quick recovery after operation.