2021 Volume 12 Issue 7 Pages 933-937
Introduction: The prevalence of osteoporotic vertebral fractures (OVFs) is increasing with the aging of the population. The majority of OVFs heal after 8-12 weeks of conservative treatment. However, some patients with OVF have neurological deficits (NDs). Reconstructive spinal surgery is often performed in patients having OVFs with NDs. However, these patients are usually elderly patients with various major morbidities. Therefore, fewer invasive interventions are required. At our institute, balloon kyphoplasty (BKP), which is a minimally invasive surgery, combined with microscopic posterior decompression was performed in patients having OVFs with NDs. The purpose of this study was to evaluate the clinical outcomes of BKP combined with microscopic posterior decompression for OVFs with NDs.
Methods: Between November 2012 and March 2020, 31 consecutive patients who underwent BKP combined with microscopic posterior decompression at our institution were included in this study. In addition, 72 patients who underwent BKP for OVF were included in the control group. Lateral views on radiography images were used to measure the local kyphotic angle preoperatively and postoperatively.
Results: The average local kyphotic angles were 14.3±18.9° preoperatively and 15.4±20.4° postoperatively. The average Japanese Orthopaedic Association (JOA) scores were 9.2±4.3° preoperatively and 13.2±6.3° postoperatively. The improvement rate was 13.0%. The differences were statistically significant in the JOA score but not in the local kyphotic angle. In the control group, the average local kyphotic angles were 15.0±10.6° preoperatively and 8.2±8.9° postoperatively. The differences were statistically significant. Compared to the control group, the correction angle was significantly smaller.
Conclusions: BKP combined with microscopic posterior decompression may only result in a smaller correction of the local kyphotic angle. However, the JOA score significantly improved following the surgery. The rate of improvement was 13.0% in this study; therefore, this method may be considered a temporary surgery rather than radical surgery. If the indication is limited, BKP combined with microscopic posterior decompression is a useful technique.
