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

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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    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., ... 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, 24(6), 1020-1026. https://doi.org/10.1016/j.jos.2019.07.018