Minimally invasive decompression with posterior column reinforcement for the treatment of symptomatic osteoporotic fracture with spinal stenosis in lumbar vertebrae.
An osteoporotic fracture (OF) in the second to fifth lumbar vertebrae with spinal stenosis may be an indication for surgical treatment, but carries the risks of instability or instrumentation failure. Modified surgical procedures have been developed to manage patients with challenging OF. We retrospectively studied 12 patients (three male, nine female; mean age±standard deviation=73.5±7.2 years) who underwent minimally invasive decompression and posterior column reinforcement with polymethylmethacrylate. During a mean follow-up period of 24.8±3.1 months, pain severity and functional impairment were both significantly reduced, as measured by the visual analog scale and the Oswestry disability index. Nine patients (75%) experienced a satisfactory outcome while the other three (25%) were unchanged. Plain radiographs showed stable spinal alignment and immobilization of flexion-extension within the PMMA construct. Five complications were managed successfully, including one by revision surgery. These procedures are a feasible surgical option in the elderly population studied.
Department of Neurosurgery, Chang Gung Memorial Hospital, 5 Fu-Hsin Street, Kweishan, Taoyuan 333, Taiwan. whhsu@adm.cgmh.org.tw
Wen-Hsing
WH
Hsu
Tai-Ngar
TN
Lui
Chen-Nen
CN
Chang
Yung-Hsin
YH
Hsu
Chih-Lung
CL
Lin
Dao-Jen
DJ
Yang
D000368:Aged; D000369:Aged, 80 and over; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D058866:Osteoporotic Fractures / Q000150:complications / Q000601:surgery*; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000379:methods*; D013130:Spinal Stenosis / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome