2021 Volume 12 Issue 9 Pages 1202-1209
Introduction: Vertebroplasty and posterior fusion for highly collapsed osteoporotic vertebral fractures have some complications such as implant failure due to postoperative correction loss. In contrast, because osteotomy and anterior fusion for super elderly over the age of 80 years are largely invasive, selecting them is difficult. Therefore, we performed surgery to fix the rod in the forward flexed lateral decubitus position to intentionally create kyphosis in anticipation of postoperative correction loss.
Methods: The subjects were 4 patients (all females) who were over the age of 80 years with highly collapsed vertebra and severe angular instability from 25° to 30° or more between the supine position and sitting position in lateral Xp images. The surgical method involved the insertion of pedicle screws initially in the supine position. Next, wound closure was performed using a primary suture, and the position was changed to the forward flexed lateral decubitus position to create kyphosis. Finally, the 5.5 mm pure titan rod was fixed.
Results: All patients had lower back pain visual analog scale of 0 mm at 6 months after the operation, and they went out on their own with little assistance. Six months after the operation, fusion was achieved in one patient and loosening of pedicle screws was observed in three patients. However, no symptoms were observed in the group of pedicle screw loosening.
Conclusions: By intentionally creating kyphosis, we were able to prevent various problems caused by correction loss and achieved good clinical results in a short duration. It appears to be a useful technique if the patients were selected by appropriate adaptation.
