Abstract
Eight patients (3 males, 5 females) with paralysis due to osteoporotic burst fractures of thoracolumbar spine underwent decompression and reconstruction with instrumentation. The average age at operation was 74.4 years. Eight patients had nine burst fractures, seven had a fracture at single level and one patient had two contiguous vertebral fractures. The most frequent level of fractured vertebra was 12th thoracic vertebra. Operative procedures were anterior/posterior in four cases, posterior in three and anterior decompression and fusion in one, using instrument. The average duration of follow-up was 47 months. Seven patients could not walk before the operation. Six of these improved by more than one grade on Frankel and Eismont classification and were able to walk after the operation. Kyphotic deformity of all patients was corrected at the operation. In six patients, loss of correction of kyphotic deformity occured during the follow-up. However, in two patients reduction of kyphotic deformity was maintained during the follow-up period. Three of the four patients in whom pedicle screw was used had loosening of the screw. Posterior instrumentation had many problems in our series. In case of short spinal fusion with posterior instrumentation, significant loss of reduction occured. One patient with anterior decompression and fusion with use of the Kaneda device and artificial vertebral spacer maintained reduction of kyphotic deformity and showed good results.
