2016 Volume 26 Issue 1 Pages 37-45
The number of osteoporotic vertebral fracture patients has been increasing in line with our aging society, which has become an serious social problem. Most patients with an osteoporotic vertebral fracture can show a good clinical course after conservative treatment. However, some patients develop prolonged low back pain or delayed neurological deterioration. It is important for us to build an appropriate system and operate on them in appropriate time. We operate about 400 times a year to treat patients with spinal disorders and have cooperated with the local medical community to treat osteoporotic vertebral fracture patients. On this occasion, the state of treatment for osteoporotic vertebral fractures at our department was investigated.
Patients diagnosed with osteoporotic vertebral fractures from January 2011, when balloon kyphoplasty (BKP) was introduced into our department, to September 2015 were retrospectively investigated. Clinical scores (JOA score, VAS, ODI) and radiological findings (vertebral body height, local kyphotic angle) of the patients who underwent an operation were evaluated. The patients who underwent BKP were followed up until 3～6 months after the operation to evaluate the immediate effect of BKP, and patients who underwent long-segment posterior fixation for 2～3 years, to evaluate the influence of instrumentation on the osteoporotic vertebral bodies.
420 patients were diagnosed as osteoporotic vertebral fractures at our department during the period. In total, 159 patients were hospitalized for treatment, and 62 patients were discharged from our department after conservative treatment. 91 BKPs (77 cases), 19 long-segment posterior fixations were performed. Only one case underwent just decompression. BKP had significantly better results until 3～6 months after the operation and was proved to give the patients immediate relief although secondary fractures sometimes occurred. Because of the fragility of the osteoporotic vertebral body, the long-segment posterior fixation with spinal instrumentation might show unfavorable result. However, relatively satisfactory condition can be obtained during 2～3 year follow up period.
The state of treatment for osteoporotic vertebral fractures at our department was investigated. Clinical scores and radiological findings of the patients who underwent BKP or long-segment posterior fixation were significantly good.
