2020 Volume 11 Issue 10 Pages 1246-1251
Introduction: Previous studies reported the usefulness of pedicle subtraction osteotomy (PSO) for kyphotic deformity caused by osteoporotic vertebral fracture. However, several reports have described about correction loss after the surgery due to loosening or migration of pedicle screw. Therefore, we applied staged surgery to prevent the problem as follows; four-segment posterior spinal fusion was performed using PSO at the collapsed vertebra as the first stage. After a week, reconstruction of anterior support was performed with placement of an expandable cylindrical cage through the osteotomy vertebra and placement of interbody cage at the caudal interbody space.
Case report: Two patients received the surgery for kyphosis associated with L1 vertebral fracture. The local kyphotic angles (T12-L2) were reduced from 41° to 8° in case 1 and 70° to 9° in case 2, respectively. The corrections were maintained during 2-year follow-up in both cases.
Conclusion: We advocate that reconstruction of anterior support is important to prevent correction loss after PSO for kyphotic deformity caused by osteoporotic vertebral fracture.
