title: Posterior vertebral column resection with 360-degree osteosynthesis in osteoporotic kyphotic deformity and spinal cord compression.
abstract: Osteoporotic fractures with severe kyphosis and neurologic deficits often require decompression and stabilisation. To reduce the risk of procedure-related complications, single-stage posterolateral vertebrectomy and a 360-degree fusion can be performed. An adequate reduction of kyphotic deformity through this approach has not been reported. The aim of this study is to investigate the efficacy of kyphotic deformity reduction by this approach in osteoporotic situation. A retrospective analysis and chart review was performed for 10 consecutive patients who underwent posterolateral decompression and posterior vertebrectomy with dorsal mesh stabilisation and reduction of kyphotic deformity. Preoperative back pain was 8.6 on a visual analogue scale; it was reduced to 5.5 at discharge and 3.7 at the latest follow-up (18 months). The Frankel score improved from D to E (three patients) or was equal (E). Radiological segmental kyphosis was corrected from a mean of 25° to 5° (p < 0.008) postoperatively with a loss of 3° at follow-up (p < 0.005). Single-stage posterolateral vertebrectomy allow for a fast and safe reconstitution/preservation of neurological function in patients with osteoporotic fracture and kyphotic deformity. A significant correction of often-accompanied hyperkyphosis is possible without neurological deterioration and with an improved sagittal profile and good pain reduction.
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University Hospital Hamburg Eppendorf, Martinistrasse 52, D-20246, Hamburg, Germany. m.dreimann@uke.de.
authors.forename: Marc
authors.initials: M
authors.lastname: Dreimann
authors.affiliation: German Scoliosis Center, Bad Wildungen, Germany.
authors.forename: Axel
authors.initials: A
authors.lastname: Hempfing
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University Hospital Hamburg Eppendorf, Martinistrasse 52, D-20246, Hamburg, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Stangenberg
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University Hospital Hamburg Eppendorf, Martinistrasse 52, D-20246, Hamburg, Germany.
authors.forename: Lennart
authors.initials: L
authors.lastname: Viezens
authors.affiliation: Department of Trauma, Orthopedic and Reconstructive Surgery, University Hospital Göttingen, Göttingen, Germany.
authors.forename: Lukas
authors.initials: L
authors.lastname: Weiser
authors.affiliation: Department of Neurosurgery, University Hospital Hamburg Eppendorf, Hamburg, Germany.
authors.forename: Patrick
authors.initials: P
authors.lastname: Czorlich
authors.affiliation: Department of Neurosurgery, University Hospital Hamburg Eppendorf, Hamburg, Germany.
authors.forename: Sven Oliver
authors.initials: SO
authors.lastname: Eicker
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019299:Decompression, Surgical; D005260:Female; D006801:Humans; D007738:Kyphosis / Q000209:etiology / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000293:injuries / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D058866:Osteoporotic Fractures / Q000150:complications / Q000601:surgery*; D010147:Pain Measurement; D011859:Radiography; D012189:Retrospective Studies; D013117:Spinal Cord Compression / Q000209:etiology / Q000601:surgery*; D013123:Spinal Fusion; D013904:Thoracic Vertebrae / Q000293:injuries / Q000601:surgery*; D016896:Treatment Outcome
keywords: Kyphosis; Osteoporotic vertebral fracture; Spinal cord compression; Vertebral column recection