Delayed Paraparesis after Osteoporotic Vertebral Fracture

Abstract

We reviewed 80 operated cases of delayed neurological disorder after osteoporotic vertebral fracture. They were divided into two groups by the suffered level: A-group, spinal cord level (T10-L1) and B-group, cauda equina level (L2-L5). We performed anterior surgery on 23 cases and posterior surgery on 57 cases. There were no significant differences in the recovery of paraparesis and ambulant ability between the anterior and posterior surgeries, but anterior surgery provided more pain relief and posterior surgery was less invasive. The A-group with anterior compression and instability showed good indication for anterior surgery and B-group with posterior compression and instability for posterior surgery, but in the intermediate cases, posterior surgery seemed to be better especially for elderly patients with some complications. In the follow-up of these patients, we experienced new fracture of other vertebra in 44% for anterior surgery and 23% for posterior surgery by an average of 16.5 months. The progressive natural course of new vertebral fractures or kyphosis of the spine for these patients with severe osteoporosis will require adequate surgery considering the long period of time after the first surgery.