Spinal external fixator distraction reduction combined with vertebroplasty in the repair of osteoporotic vertebral fractures

Li Zhu; Wang Wen-jun; Yao Nv-zhao; Song Xi-zheng

doi:10.3969/j.issn.2095-4344.2014.31.012

Abstract：BACKGROUND:Percutaneous vertebroplasty is an effective minimal y invasive method in the treatment of osteoporotic vertebral compression fractures. However, there are some shortcomings during clinical application, such as cannot recover vertebral height or correct local kyphosis, as wel as the incidence of cement leakage is very high. <br> OBJECTIVE:To evaluate the latest clinical effect of spinal external fixator distraction reduction combined with vertebroplasty for osteoporotic vertebral fractures. <br> METHODS:From January 2012 to June 2013, 55 sever osteoporotic fracture patients accepted the treatment of spinal external fixator distraction reduction combined with vertebroplasty. During the operation, we firstly used percutaneous pedicle screw fixator to open the closed reduction and to correct the kyphosis, fol owed by vertebroplasty via percutaneous puncture. Then we measured the compression rate of vertebral body of compression fracture, the kyphosis angle and the rate of intraspinal occupancy before and after operation. Meanwhile, we evaluated the clinical effect with Visual Analogue Scale and Oswestry disability index. <br> RESULTS AND CONCLUSION:Visual Analogue Scale scores and Oswestry disability index were significantly improved after treatment and during final fol ow-up (P<0.05). Low back pain was basical y relieved. The patients could do out-of-bed activity at 1-3 days after treatment. Among the 57 vertebral bodies of 55 cases, 4 suffered from the cement leakage without obvious clinical symptoms. The height of vertebral compression fracture, the kyphosis angle, and the rate of intraspinal occupancy were significantly improved after the spinal external fixator combined with vertebroplasty and during the last fol ow-up (P<0.05), and no significant difference was detected between postoperation and final fol ow-up. These data indicated that spinal external fixator distraction reduction combined with percutaneous vertebroplasty for severe osteoporotic vertebral compression fractures is a safe effective minimal y invasive method with stable therapeutic effects. Cement leakage rate was low, and spinal stability was satisfactory.