Abstract
Osteoporotic compression fractures cause back pain and kyphosis. These fractures are usually treated conservatively and heal without neurological deficit in most cases. In a few cases, however, late-onset paraparesis can result from delayed vertebral body collapse, and this requires surgical treatment.
We present the clinical results obtained in 6 patients who underwent vertebroplasty using calcium phosphate cement (CPC) for late-onset paraparesis due to osteoporotic vertebral collapse. The preoperative neurologic status was incomplete paralysis in all patients. The average age was 82 (79∼90) years, and the average follow-up period was 24 (12∼34) months. The affected verebral level was T12 in 5 patients and L 1 in one.
The average operation time was 78 minutes, and the average total blood loss was 20ml.
Neurological deficits were ameliorated in all patients, and back pain was improved significantly. There were no postoperative complications.
The factors responsible for neurological deficits due to osteoporotic vertebral collapse were retropulsed bony fragments from the collapsed vertebral body into the spinal canal and kyphosis with instability. After CPC vertebroplasty, the local kyphosis was markedly corrected and spinal stability was restored. This type of surgery could be a good choice for treating late-onset paraparesis after osteoporotic vertebral collapse caused by local angular kyphosis and instability, rather than spinal cord compression of retropulsed bony fragments.
