Study Design: A retrospective study.
Objectives: To analyze the clinical and radiological results of different surgical methods in osteoporotic vertebral fracture patier as, with neurologic deficits in the thoracolumbar junction.
Surm iary of Literature review: Various surgical methods have been reported for osteoporotic vertebral fractures, with neurologic deficits, in the thoracolumbar junction. These are: anterior decompression, anterior decompression and anterior or posterior recor struction, and Egg shell procedure. However, it is controversial as to which method is better.
Materials and Methods: 13 patients that had undergone surgical treatment for osteoporotic vertebral fractures, with neurologic deficits, With a mean age of 688.4, ranging from 51 to 79 years. Six of the cases were male and seven were female. The mean follo, v up period was 18 months. The patients were divided into two groups.
Gr )up A (n=8): Anterior decompression, anterior interbody fusion, with cage or autologous strut iliac bone block, and instrument ition (anterior or posterior).
Gr )up B (n=5): Posterior decompression and posterior reconstruction (egg shell procedure).
The kyphotic angles, neurologic improvements and complications in each group were analyzed preoperatively, postoperatively and it final follow up.
Results: In group A, the mean kyphotic angles were 295.9,186.7 and 237.7 preoperatively, postoperatively and at the Tina, follow up, respectively. In group B, the mean kyphotic angles were 311.1,126.3 and 185.5 preoperatively, postopertively and at the final follow up, respectively. In group A, 3 and 5 patients were graded as Frankel grades C and D, respectiv ly. In group B,1, 1 and 3 patients were graded as Frankel grades B, C and D, respectively. The neurological status improved in ill the patients, by mean 1.1 grades in group A and 12 grades in group B. In group A, postoperative transient dyspnea and scI -w loosening occurred in one and two patients, respectively. In group B, postoperative paralytic ileus and screw loosening oa urred in one two patients, respectively.
Conclusion: Posterior decompression and posterior reconstruction (egg shell procedure) was an effective surgical method, equival, nt to an anterior or anterior and posterior procedure, for osteoporotic vertebral fracture patients, with neurologic deficits.
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