Percutaneous Pedicle Screw Fixation with Polymethylmethacrylate Augmentation for the Treatment of Thoracolumbar Intravertebral Pseudoarthrosis Associated with Kummell's Osteonecrosis.
Purpose. The purpose of our study is to evaluate the therapeutic efficacy of short-segment percutaneous pedicle screw fixation with polymethylmethacrylate (PMMA) augmentation for the treatment of osteoporotic thoracolumbar compression fracture with osteonecrosis. Methods. Osteoporotic thoracolumbar compression fractures with avascular necrosis were treated by short-segment PPF with PMMA augmentation. Eighteen were followed up for more than 2 years. The kyphotic angle, compression ratio, visual analog scale (VAS) score for back pain, and the Oswestry Disability Index (ODI) were analyzed. In addition, radiologic and clinical parameters of PPF group were compared with percutaneous vertebroplasty (PVP) group. Results. Vertebral height and kyphotic angle of the compressed vertebral bodies were significantly corrected after the operation (P < 0.05). Further, restored vertebral height was maintained during the 2 or more years of postoperative follow-up. Compared to the PVP group the postoperative compression ratio and kyphotic angle were significantly lower in the PPF group (P < 0.05). The postoperative ODI and VAS of the PVP group were significantly higher than the PPF (P < 0.05). Conclusions. According to our results, short-segment PPF with PMMA augmentation may be an effective minimally invasive treatment for osteoporosis in cases of osteoporotic vertebral compression fractures with Kummell's osteonecrosis.
Department of Neurosurgery, Spine Center, Nanoori Hospital, Suwon 16503, Republic of Korea.
Hyeun-Sung
0000-0001-5361-5234
HS
Kim
Department of Neurosurgery, Spine Center, The Leon Wiltse Memorial Hospital, Suwon 16480, Republic of Korea.
Dong-Hwa
0000-0003-1203-4550
DH
Heo
D000368:Aged; D001843:Bone Cements / Q000627:therapeutic use; D003131:Combined Modality Therapy / Q000295:instrumentation / Q000379:methods; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods; D006801:Humans; D008297:Male; D010020:Osteonecrosis / Q000150:complications / Q000628:therapy*; D065289:Pedicle Screws; D019904:Polymethyl Methacrylate / Q000627:therapeutic use*; D011474:Prosthesis Design; D019919:Prosthesis Implantation / Q000379:methods; D011542:Pseudarthrosis / Q000209:etiology / Q000628:therapy*; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000209:etiology / Q000628:therapy*; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods; D013904:Thoracic Vertebrae / Q000293:injuries / Q000601:surgery; D016896:Treatment Outcome; D054854:Vertebroplasty / Q000295:instrumentation* / Q000379:methods
D001843:Bone Cements; D019904:Polymethyl Methacrylate