Surgical outcomes of spinal fusion for osteoporotic vertebral fracture in the thoracolumbar spine: Comprehensive evaluations of 5 typical surgical fusion techniques

Kei Watanabe, Keiichi Katsumi, Masayuki Ohashi, Yohei Shibuya, Toru Hirano, Naoto Endo, Takashi Kaito, Tomoya Yamashita, Hiroyasu Fujiwara, Yukitaka Nagamoto, Yuji Matsuoka, Hidekazu Suzuki, Hirosuke Nishimura, Hidetomi Terai, Koji Tamai, Atsushi Tagami, Syuta Yamada, Shinji Adachi, Toshitaka Yoshii, Shuta UshioKatsumi Harimaya, Kenichi Kawaguchi, Nobuhiko Yokoyama, Hidekazu Oishi, Toshiro Doi, Atsushi Kimura, Hirokazu Inoue, Gen Inoue, Masayuki Miyagi, Wataru Saito, Atsushi Nakano, Daisuke Sakai, Tadashi Nukaga, Shota Ikegami, Masayuki Shimizu, Toshimasa Futatsugi, Seiji Ohtori, Takeo Furuya, Sumihisa Orita, Shiro Imagama, Kei Ando, Kazuyoshi Kobayashi, Katsuhito Kiyasu, Hideki Murakami, Katsuhito Yoshioka, Shoji Seki, Michio Hongo, Kenichiro Kakutani, Takashi Yurube, Yasuchika Aoki, Masashi Oshima, Masahiko Takahata, Akira Iwata, Hirooki Endo, Tetsuya Abe, Toshinori Tsukanishi, Kazuyoshi Nakanishi, Kota Watanabe, Tomohiro Hikata, Satoshi Suzuki, Norihiro Isogai, Eijiro Okada, Haruki Funao, Seiji Ueda, Yuta Shiono, Kenya Nojiri, Naobumi Hosogane, Ken Ishii

Research output: Contribution to journalArticle

Abstract

Background: A consensus on the optimal surgical procedure for thoracolumbar OVF has yet to be reached due to the previous relatively small number of case series. The study was conducted to investigate surgical outcomes for osteoporotic vertebral fracture (OVF) in the thoracolumbar spine. Methods: In total, 315 OVF patients (mean age, 74 years; 68 men and 247 women) with neurological symptoms who underwent spinal fusion with a minimum 2-year follow-up were included. The patients were divided into 5 groups by procedure: anterior spinal fusion alone (ASF group, n = 19), anterior/posterior combined fusion (APSF group, n = 27), posterior spinal fusion alone (PSF group, n = 40), PSF with 3-column osteotomy (3CO group, n = 92), and PSF with vertebroplasty (VP + PSF group, n = 137). Results: Mean operation time was longer in the APSF group (p < 0.05), and intraoperative blood loss was lower in the VP + PSF group (p < 0.05). The amount of local kyphosis correction was greater in the APSF and 3CO groups (p < 0.05). Clinical outcomes were approximately equivalent among all groups. Conclusion: All 5 procedures resulted in acceptable neurological outcomes and functional improvement in walking ability. Moreover, they were similar with regard to complication rates, prevalence of mechanical failure related to the instrumentation, and subsequent vertebral fracture. Individual surgical techniques can be adapted to suit patient condition or severity of OVF.

Original languageEnglish
Pages (from-to)1020-1026
Number of pages7
JournalJournal of Orthopaedic Science
Volume24
Issue number6
DOIs
Publication statusPublished - 2019 Nov

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Spinal Fusion
Osteoporotic Fractures
Spine
Vertebroplasty
Kyphosis
Osteotomy
Walking

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Surgical outcomes of spinal fusion for osteoporotic vertebral fracture in the thoracolumbar spine : Comprehensive evaluations of 5 typical surgical fusion techniques. / Watanabe, Kei; Katsumi, Keiichi; Ohashi, Masayuki; Shibuya, Yohei; Hirano, Toru; Endo, Naoto; Kaito, Takashi; Yamashita, Tomoya; Fujiwara, Hiroyasu; Nagamoto, Yukitaka; Matsuoka, Yuji; Suzuki, Hidekazu; Nishimura, Hirosuke; Terai, Hidetomi; Tamai, Koji; Tagami, Atsushi; Yamada, Syuta; Adachi, Shinji; Yoshii, Toshitaka; Ushio, Shuta; Harimaya, Katsumi; Kawaguchi, Kenichi; Yokoyama, Nobuhiko; Oishi, Hidekazu; Doi, Toshiro; Kimura, Atsushi; Inoue, Hirokazu; Inoue, Gen; Miyagi, Masayuki; Saito, Wataru; Nakano, Atsushi; Sakai, Daisuke; Nukaga, Tadashi; Ikegami, Shota; Shimizu, Masayuki; Futatsugi, Toshimasa; Ohtori, Seiji; Furuya, Takeo; Orita, Sumihisa; Imagama, Shiro; Ando, Kei; Kobayashi, Kazuyoshi; Kiyasu, Katsuhito; Murakami, Hideki; Yoshioka, Katsuhito; Seki, Shoji; Hongo, Michio; Kakutani, Kenichiro; Yurube, Takashi; Aoki, Yasuchika; Oshima, Masashi; Takahata, Masahiko; Iwata, Akira; Endo, Hirooki; Abe, Tetsuya; Tsukanishi, Toshinori; Nakanishi, Kazuyoshi; Watanabe, Kota; Hikata, Tomohiro; Suzuki, Satoshi; Isogai, Norihiro; Okada, Eijiro; Funao, Haruki; Ueda, Seiji; Shiono, Yuta; Nojiri, Kenya; Hosogane, Naobumi; Ishii, Ken.

In: Journal of Orthopaedic Science, Vol. 24, No. 6, 11.2019, p. 1020-1026.

Research output: Contribution to journalArticle

Watanabe, K, Katsumi, K, Ohashi, M, Shibuya, Y, Hirano, T, Endo, N, Kaito, T, Yamashita, T, Fujiwara, H, Nagamoto, Y, Matsuoka, Y, Suzuki, H, Nishimura, H, Terai, H, Tamai, K, Tagami, A, Yamada, S, Adachi, S, Yoshii, T, Ushio, S, Harimaya, K, Kawaguchi, K, Yokoyama, N, Oishi, H, Doi, T, Kimura, A, Inoue, H, Inoue, G, Miyagi, M, Saito, W, Nakano, A, Sakai, D, Nukaga, T, Ikegami, S, Shimizu, M, Futatsugi, T, Ohtori, S, Furuya, T, Orita, S, Imagama, S, Ando, K, Kobayashi, K, Kiyasu, K, Murakami, H, Yoshioka, K, Seki, S, Hongo, M, Kakutani, K, Yurube, T, Aoki, Y, Oshima, M, Takahata, M, Iwata, A, Endo, H, Abe, T, Tsukanishi, T, Nakanishi, K, Watanabe, K, Hikata, T, Suzuki, S, Isogai, N, Okada, E, Funao, H, Ueda, S, Shiono, Y, Nojiri, K, Hosogane, N & Ishii, K 2019, 'Surgical outcomes of spinal fusion for osteoporotic vertebral fracture in the thoracolumbar spine: Comprehensive evaluations of 5 typical surgical fusion techniques', Journal of Orthopaedic Science, vol. 24, no. 6, pp. 1020-1026. https://doi.org/10.1016/j.jos.2019.07.018
Watanabe, Kei ; Katsumi, Keiichi ; Ohashi, Masayuki ; Shibuya, Yohei ; Hirano, Toru ; Endo, Naoto ; Kaito, Takashi ; Yamashita, Tomoya ; Fujiwara, Hiroyasu ; Nagamoto, Yukitaka ; Matsuoka, Yuji ; Suzuki, Hidekazu ; Nishimura, Hirosuke ; Terai, Hidetomi ; Tamai, Koji ; Tagami, Atsushi ; Yamada, Syuta ; Adachi, Shinji ; Yoshii, Toshitaka ; Ushio, Shuta ; Harimaya, Katsumi ; Kawaguchi, Kenichi ; Yokoyama, Nobuhiko ; Oishi, Hidekazu ; Doi, Toshiro ; Kimura, Atsushi ; Inoue, Hirokazu ; Inoue, Gen ; Miyagi, Masayuki ; Saito, Wataru ; Nakano, Atsushi ; Sakai, Daisuke ; Nukaga, Tadashi ; Ikegami, Shota ; Shimizu, Masayuki ; Futatsugi, Toshimasa ; Ohtori, Seiji ; Furuya, Takeo ; Orita, Sumihisa ; Imagama, Shiro ; Ando, Kei ; Kobayashi, Kazuyoshi ; Kiyasu, Katsuhito ; Murakami, Hideki ; Yoshioka, Katsuhito ; Seki, Shoji ; Hongo, Michio ; Kakutani, Kenichiro ; Yurube, Takashi ; Aoki, Yasuchika ; Oshima, Masashi ; Takahata, Masahiko ; Iwata, Akira ; Endo, Hirooki ; Abe, Tetsuya ; Tsukanishi, Toshinori ; Nakanishi, Kazuyoshi ; Watanabe, Kota ; Hikata, Tomohiro ; Suzuki, Satoshi ; Isogai, Norihiro ; Okada, Eijiro ; Funao, Haruki ; Ueda, Seiji ; Shiono, Yuta ; Nojiri, Kenya ; Hosogane, Naobumi ; Ishii, Ken. / Surgical outcomes of spinal fusion for osteoporotic vertebral fracture in the thoracolumbar spine : Comprehensive evaluations of 5 typical surgical fusion techniques. In: Journal of Orthopaedic Science. 2019 ; Vol. 24, No. 6. pp. 1020-1026.
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abstract = "Background: A consensus on the optimal surgical procedure for thoracolumbar OVF has yet to be reached due to the previous relatively small number of case series. The study was conducted to investigate surgical outcomes for osteoporotic vertebral fracture (OVF) in the thoracolumbar spine. Methods: In total, 315 OVF patients (mean age, 74 years; 68 men and 247 women) with neurological symptoms who underwent spinal fusion with a minimum 2-year follow-up were included. The patients were divided into 5 groups by procedure: anterior spinal fusion alone (ASF group, n = 19), anterior/posterior combined fusion (APSF group, n = 27), posterior spinal fusion alone (PSF group, n = 40), PSF with 3-column osteotomy (3CO group, n = 92), and PSF with vertebroplasty (VP + PSF group, n = 137). Results: Mean operation time was longer in the APSF group (p < 0.05), and intraoperative blood loss was lower in the VP + PSF group (p < 0.05). The amount of local kyphosis correction was greater in the APSF and 3CO groups (p < 0.05). Clinical outcomes were approximately equivalent among all groups. Conclusion: All 5 procedures resulted in acceptable neurological outcomes and functional improvement in walking ability. Moreover, they were similar with regard to complication rates, prevalence of mechanical failure related to the instrumentation, and subsequent vertebral fracture. Individual surgical techniques can be adapted to suit patient condition or severity of OVF.",
author = "Kei Watanabe and Keiichi Katsumi and Masayuki Ohashi and Yohei Shibuya and Toru Hirano and Naoto Endo and Takashi Kaito and Tomoya Yamashita and Hiroyasu Fujiwara and Yukitaka Nagamoto and Yuji Matsuoka and Hidekazu Suzuki and Hirosuke Nishimura and Hidetomi Terai and Koji Tamai and Atsushi Tagami and Syuta Yamada and Shinji Adachi and Toshitaka Yoshii and Shuta Ushio and Katsumi Harimaya and Kenichi Kawaguchi and Nobuhiko Yokoyama and Hidekazu Oishi and Toshiro Doi and Atsushi Kimura and Hirokazu Inoue and Gen Inoue and Masayuki Miyagi and Wataru Saito and Atsushi Nakano and Daisuke Sakai and Tadashi Nukaga and Shota Ikegami and Masayuki Shimizu and Toshimasa Futatsugi and Seiji Ohtori and Takeo Furuya and Sumihisa Orita and Shiro Imagama and Kei Ando and Kazuyoshi Kobayashi and Katsuhito Kiyasu and Hideki Murakami and Katsuhito Yoshioka and Shoji Seki and Michio Hongo and Kenichiro Kakutani and Takashi Yurube and Yasuchika Aoki and Masashi Oshima and Masahiko Takahata and Akira Iwata and Hirooki Endo and Tetsuya Abe and Toshinori Tsukanishi and Kazuyoshi Nakanishi and Kota Watanabe and Tomohiro Hikata and Satoshi Suzuki and Norihiro Isogai and Eijiro Okada and Haruki Funao and Seiji Ueda and Yuta Shiono and Kenya Nojiri and Naobumi Hosogane and Ken Ishii",
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T1 - Surgical outcomes of spinal fusion for osteoporotic vertebral fracture in the thoracolumbar spine

T2 - Comprehensive evaluations of 5 typical surgical fusion techniques

AU - Watanabe, Kei

AU - Katsumi, Keiichi

AU - Ohashi, Masayuki

AU - Shibuya, Yohei

AU - Hirano, Toru

AU - Endo, Naoto

AU - Kaito, Takashi

AU - Yamashita, Tomoya

AU - Fujiwara, Hiroyasu

AU - Nagamoto, Yukitaka

AU - Matsuoka, Yuji

AU - Suzuki, Hidekazu

AU - Nishimura, Hirosuke

AU - Terai, Hidetomi

AU - Tamai, Koji

AU - Tagami, Atsushi

AU - Yamada, Syuta

AU - Adachi, Shinji

AU - Yoshii, Toshitaka

AU - Ushio, Shuta

AU - Harimaya, Katsumi

AU - Kawaguchi, Kenichi

AU - Yokoyama, Nobuhiko

AU - Oishi, Hidekazu

AU - Doi, Toshiro

AU - Kimura, Atsushi

AU - Inoue, Hirokazu

AU - Inoue, Gen

AU - Miyagi, Masayuki

AU - Saito, Wataru

AU - Nakano, Atsushi

AU - Sakai, Daisuke

AU - Nukaga, Tadashi

AU - Ikegami, Shota

AU - Shimizu, Masayuki

AU - Futatsugi, Toshimasa

AU - Ohtori, Seiji

AU - Furuya, Takeo

AU - Orita, Sumihisa

AU - Imagama, Shiro

AU - Ando, Kei

AU - Kobayashi, Kazuyoshi

AU - Kiyasu, Katsuhito

AU - Murakami, Hideki

AU - Yoshioka, Katsuhito

AU - Seki, Shoji

AU - Hongo, Michio

AU - Kakutani, Kenichiro

AU - Yurube, Takashi

AU - Aoki, Yasuchika

AU - Oshima, Masashi

AU - Takahata, Masahiko

AU - Iwata, Akira

AU - Endo, Hirooki

AU - Abe, Tetsuya

AU - Tsukanishi, Toshinori

AU - Nakanishi, Kazuyoshi

AU - Watanabe, Kota

AU - Hikata, Tomohiro

AU - Suzuki, Satoshi

AU - Isogai, Norihiro

AU - Okada, Eijiro

AU - Funao, Haruki

AU - Ueda, Seiji

AU - Shiono, Yuta

AU - Nojiri, Kenya

AU - Hosogane, Naobumi

AU - Ishii, Ken

PY - 2019/11

Y1 - 2019/11

N2 - Background: A consensus on the optimal surgical procedure for thoracolumbar OVF has yet to be reached due to the previous relatively small number of case series. The study was conducted to investigate surgical outcomes for osteoporotic vertebral fracture (OVF) in the thoracolumbar spine. Methods: In total, 315 OVF patients (mean age, 74 years; 68 men and 247 women) with neurological symptoms who underwent spinal fusion with a minimum 2-year follow-up were included. The patients were divided into 5 groups by procedure: anterior spinal fusion alone (ASF group, n = 19), anterior/posterior combined fusion (APSF group, n = 27), posterior spinal fusion alone (PSF group, n = 40), PSF with 3-column osteotomy (3CO group, n = 92), and PSF with vertebroplasty (VP + PSF group, n = 137). Results: Mean operation time was longer in the APSF group (p < 0.05), and intraoperative blood loss was lower in the VP + PSF group (p < 0.05). The amount of local kyphosis correction was greater in the APSF and 3CO groups (p < 0.05). Clinical outcomes were approximately equivalent among all groups. Conclusion: All 5 procedures resulted in acceptable neurological outcomes and functional improvement in walking ability. Moreover, they were similar with regard to complication rates, prevalence of mechanical failure related to the instrumentation, and subsequent vertebral fracture. Individual surgical techniques can be adapted to suit patient condition or severity of OVF.

AB - Background: A consensus on the optimal surgical procedure for thoracolumbar OVF has yet to be reached due to the previous relatively small number of case series. The study was conducted to investigate surgical outcomes for osteoporotic vertebral fracture (OVF) in the thoracolumbar spine. Methods: In total, 315 OVF patients (mean age, 74 years; 68 men and 247 women) with neurological symptoms who underwent spinal fusion with a minimum 2-year follow-up were included. The patients were divided into 5 groups by procedure: anterior spinal fusion alone (ASF group, n = 19), anterior/posterior combined fusion (APSF group, n = 27), posterior spinal fusion alone (PSF group, n = 40), PSF with 3-column osteotomy (3CO group, n = 92), and PSF with vertebroplasty (VP + PSF group, n = 137). Results: Mean operation time was longer in the APSF group (p < 0.05), and intraoperative blood loss was lower in the VP + PSF group (p < 0.05). The amount of local kyphosis correction was greater in the APSF and 3CO groups (p < 0.05). Clinical outcomes were approximately equivalent among all groups. Conclusion: All 5 procedures resulted in acceptable neurological outcomes and functional improvement in walking ability. Moreover, they were similar with regard to complication rates, prevalence of mechanical failure related to the instrumentation, and subsequent vertebral fracture. Individual surgical techniques can be adapted to suit patient condition or severity of OVF.

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