Correction of osteoporotic fracture deformities with global sagittal imbalance.

Abstract:

UNLABELLED:Osteoporotic spinal deformities with global sagittal imbalance have devastating effects on patients. However, treatment is difficult and there is a high risk of perioperative medical and mechanical complications. Patients with osteoporotic spinal deformities are not ideal candidates for posterior pedicle subtraction osteotomy; the condition necessitates combined anterior-posterior for corrections of the deformity. We ascertained the complication rates and efficacy of the anterior-posterior surgery and determined the factors influencing the results. To determine complication rates we analyzed a series of patients (n = 32). To evaluate overall results, we analyzed 18 patients with more than 2-years followup. A total of 18 complications occurred in 12 of 32 patients (37.5%) with seven early complications occurring in five patients and 11 delayed complications occurring in seven patients. Three patients needed additional surgery to treat the complications. At 2 years postoperatively, 17 of 18 patients (94%) reported subjective improvement with 54% decrement of Oswestry Disability Index and 70% decrement of the visual analogue scale pain score. The factors associated with clinical improvement was restoration of total lumbopelvic lordosis, C7 plumb, and control of T4-12 thoracic kyphosis. Prevention and aggressive treatment of junctional fractures were important in achieving favorable results. LEVEL OF EVIDENCE:Therapeutic study, Level IV (case series, [patients treated one way with no comparison group of patients treated in another way]). See the Guidelines for Authors for a complete description of the levels of evidence.

journal_name

Clin Orthop Relat Res

authors

Kim WJ,Lee ES,Jeon SH,Yalug I

doi

10.1097/01.blo.0000200237.22308.93

subject

Has Abstract

pub_date

2006-02-01 00:00:00

pages

75-93

eissn

0009-921X

issn

1528-1132

pii

00003086-200602000-00015

journal_volume

443

pub_type

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