title: [The application of biopsy and kyphoplasty in the diagnosis and treatment of osteoporotic thoracolumbar vertebral compression fracture nonunion].
abstract: OBJECTIVE
  To investigate the clinical efficacy and safety of biopsy and Kyphoplasty in the diagnosis and treatment of osteoporotic thoracolumbar vertebral fracture nonunion, and to explore the clinical characteristics of the disease.
  
  
  METHODS
  From July 2005 to May 2010, the clinical data of 8 patients with nonunion of osteoporotic thoracolumbar vertebral fractures were studied. There were 3 males and 5 females, with the mean age of 73.5 years (range, 65 - 86 years). The fracture vertebrae were 3 cases in T(12), 4 in L(1), and 1 in L(2). All cases received radiography, CT and MRI examination. All patients were treated by using Kyphoplasty. Five patients were performed bone biopsy successfully, 3 patients were failed. The curative effect was evaluated by visual analogue scale (VAS), anterior vertebral height restoration at preoperative, postoperative and followed-up time.
  
  
  RESULTS
  All patients tolerated the procedure well with immediate relief of back pain after Kyphoplasty. No severe complications were found in all patients. Three cases had the pathologic appearance of sequestrum, 2 cases were sparse cancellous bone, 3 cases were abortive to biopsy. All the patients were followed up of 22.6 months (range, 3 - 37 months), the VAS was 9.5 before operation, 2.1 at the third day postoperatively, there were significant difference between the two phase (P < 0.05), and 2.3 at last follow-up, there were no difference between postoperation and follow-up phase (P > 0.05). And the height of compressed body recovered markedly. The vertebral height had a recovery rate of 67.2% postoperatively, 64.1% and at last follow-up, there were no difference between the two phase (P > 0.05).
  
  
  CONCLUSIONS
  Kyphoplasty is an effective and safe method in the treatment of osteoporotic throacolumbar vertebral fracture nonunion. Bone biopsy can play a further role of differential diagnosis.
authors: Department of Spine Surgery, Nanjing Medical University, Nanjing 210006, China.
authors: Da-lin
authors: DL
authors: Wang
authors: Li-ming
authors: LM
authors: Wang
authors: Jie
authors: J
authors: Xu
authors: Yi-wen
authors: YW
authors: Zeng
authors: Gang-rui
authors: GR
authors: Wang
authors: Sheng-nai
authors: SN
authors: Zheng