title: Surgical treatment for osteoporotic thoracolumbar vertebral collapse using vertebroplasty with posterior spinal fusion: a prospective multicenter study.
abstract: The study aimed to investigate the clinical outcomes and limitations after vertebroplasty with posterior spinal fusion (VP+PSF) without neural decompression for osteoporotic vertebral collapse.
  
  
  
  We conducted a prospective multicenter study including 45 patients (12 men and 33 women, mean age: 77.0 years) evaluated between 2008 and 2012. Operation time, blood loss, visual analog scale (VAS) of back pain, neurological status, kyphosis angle in the fused area, and vertebral union of the collapsed vertebra were evaluated.
  
  
  
  The mean operation time was 162 min and blood loss was 381 mL. The postoperative VAS score significantly improved, and the neurological status improved in 35 patients (83 %), and none of the remaining patients demonstrated a deteriorating neurological status at two years post-operatively. The mean kyphosis angle pre-operatively, immediately post-operatively, and two years post-operatively was 23.8°, 10.7°, and 24.3°, respectively, and there was no significant difference between the angles pre-operatively and two years post-operatively. The extensive correction of kyphosis >16° was a risk factor for a higher correction loss and subsequent fracture. Union of the collapsed vertebra was observed in 43 patients (95 %) at two years post-operatively.
  
  
  
  The present study suggests that spinal stabilization rather than neural decompression is essential to treat OVC. Short-segment VP+PSF can achieve a high union rate of collapsed vertebra and provide a significant improvement in back pain or neurological status with less invasive surgery, but has a limit of kyphosis correction more than 16°.
authors.affiliation: Department of Orthopedic Surgery, Niigata University Medical and Dental General Hospital, 1-757 Asahimachidori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan. kkatsu_os@yahoo.co.jp.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Katsumi
authors.affiliation: Department of Orthopedic Surgery, Niigata University Medical and Dental General Hospital, 1-757 Asahimachidori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Hirano
authors.affiliation: Department of Orthopedic Surgery, Niigata University Medical and Dental General Hospital, 1-757 Asahimachidori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan.
authors.forename: Kei
authors.initials: K
authors.lastname: Watanabe
authors.affiliation: Department of Orthopedic Surgery, Niigata University Medical and Dental General Hospital, 1-757 Asahimachidori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Ohashi
authors.affiliation: Spine Center, Department of Orthopaedic Surgery, Niigata Central Hospital, Niigata City, Niigata, Japan.
authors.forename: Akiyoshi
authors.initials: A
authors.lastname: Yamazaki
authors.affiliation: Department of Orthopedic Surgery, Niigata City General Hospital, Niigata City, Niigata, Japan.
authors.forename: Takui
authors.initials: T
authors.lastname: Ito
authors.affiliation: Department of Orthopedic Surgery, Niigata City General Hospital, Niigata City, Niigata, Japan.
authors.forename: Kimihiko
authors.initials: K
authors.lastname: Sawakami
authors.affiliation: Department of Orthopedic Surgery, Niigata Prefectural Shibata Hospital, Shibata City, Niigata, Japan.
authors.forename: Atsuki
authors.initials: A
authors.lastname: Sano
authors.affiliation: Department of Orthopedic Surgery, Niigata Rosai Hospital, Joetsu City, Niigata, Japan.
authors.forename: Ren
authors.initials: R
authors.lastname: Kikuchi
authors.affiliation: Department of Orthopedic Surgery, Niigata University Medical and Dental General Hospital, 1-757 Asahimachidori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan.
authors.forename: Naoto
authors.initials: N
authors.lastname: Endo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019299:Decompression, Surgical; D005260:Female; D050815:Fractures, Compression / Q000601:surgery*; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications*; D058866:Osteoporotic Fractures / Q000601:surgery*; D011446:Prospective Studies; D016103:Spinal Fractures / Q000601:surgery*; D013123:Spinal Fusion; D013904:Thoracic Vertebrae / Q000601:surgery; D054854:Vertebroplasty
keywords: Correction loss; Osteoporosis; Osteoporotic vertebral collapse; Prospective study; Subsequent fracture; Vertebroplasty with posterior spinal fusion