title: Two kinds of posterior approach for Kvmmell's disease after osteoporotic thoracolumbar fracture.
abstract: OBJECTIVE
  To compare the surgical results of two kinds of posterior approach for osteoporotic thoracolumbar Kvmmell's disease.
  
  
  METHODS
  Clinical and radiographic results of 1-segmental pedicle screw fixation combined with vertebroplasty (Group A, n equal to 12) or posterior shortening osteotomy (Group B, n equal to 16) for osteoporotic thoracolumbar Kvmmell's disease were analyzed retrospectively. Japanese orthopedic association (JOA) and visual analogue scale (VAS) scores were used for clinical evaluation. Neurological status was judged by Frankel grades. X-ray was used to evaluate the radiographic results. Complications related to operation and devices were also considered.
  
  
  RESULTS
  The follow-up period was 12-54 months (average 29 months). Pre-and post-operative VAS were 9.3 and 3.2 in Group A, 8.9 and 2.5 in Group B, respectively. The mean JOA score at the final follow-up was significantly higher than that of pre-operation (t equal to 5.306, P less than 0.001). There was no significant difference between Groups A and B (t equal to 0.618, P larger than 0.05). The kyphosis were corrected from preoperative 33.9 degree A)/37.3 degree B) to postoperative 10.3 degree A)/6.5 degree B), and 15.3 degree (A)/13.7 degree B) at the final follow-up. There was a significant difference between the two groups at the final follow-up. Frankel grade was improved from grade C preoperatively to postoperatively grade D or E in 7 cases of Group A and 5 cases of Group B, from grade D to E in 5 cases of Group A and 11 cases of Group B. The mean improvement was 1.6 and 1.7 grades for Groups A and B, respectively. There were no serious complications related to internal fixation.
  
  
  CONCLUSIONS
  The similar clinical results can be obtained by the two kinds of posterior surgical methods for osteoporotic Kvmmell's disease. Posterior spinal shortening is a better choice for patients with serious kyphosis combined with neurological deficit than the other.
authors.affiliation: Department of Spinal Surgery, First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510700, China. houqinglong@163.com
authors.forename: Hou-Qing
authors.initials: HQ
authors.lastname: Long
authors.forename: Yong
authors.initials: Y
authors.lastname: Wan
authors.forename: Xin
authors.initials: X
authors.lastname: Zhang
authors.forename: Shao-Yu
authors.initials: SY
authors.lastname: Liu
authors.forename: Fo-Bao
authors.initials: FB
authors.lastname: Li
mesh_terms: D000368:Aged; D001863:Bone Screws; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007738:Kyphosis / Q000601:surgery; D008159:Lumbar Vertebrae / Q000293:injuries* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications*; D010027:Osteotomy; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000293:injuries* / Q000601:surgery; D054854:Vertebroplasty