Effectiveness of limited middle and posterior column osteotomy via transvertebral space approach for old thoracolumbar compression fracture_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 MA Zheng ¹ , DING Wenyuan ² , JIAO Jianbao ¹ , CHEN Taoping ¹ , QIAN Ligang ¹ , CHEN Kang ¹

1. Department of Orthopedics, Affiliated Hospital of Hebei University, Baoding Hebei, 071000, P.R.China;
2. Department of Spinal Surgery, the Third Hospital of Hebei Medical University, Shijiazhuang Hebei, 050000, P.R.China;

Corresponding author：

MA Zheng, Email: mazheng2012@qq.com

Keywords：

Old thoracolumbar compression fracture; kyphosis deformity; osteotomy and orthopaedic surgery

DOI：

10.7507/1002-1892.202102027

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the effectiveness of limited middle and posterior column osteotomy via transvertebral space approach in treatment of old thoracolumbar compression fracture.Methods A clinical data of 47 patients with old thoracolumbar compression fractures, who met the selection criteria between January 2010 and March 2018, was retrospectively analyzed. Twenty-five patients (group A) underwent the limited middle and posterior column osteotomy via transvertebral space approach, and 22 patients (group B) underwent the pedicle subtraction osteotomy (PSO). There was no significant difference in gender, age, cause of injury, time from injury to operation, fracture segment, and preoperative Cobb angle, sagittal vertical axis (SVA), visual analogue scale (VAS) score, Japanese Orthopaedic Association (JOA) score, and Oswestry disability index (ODI) between the two groups (P>0.05). The operation time, intraoperative blood loss, and postoperative complications, as well as postoperative Cobb angle, SVA, VAS score, JOA score, ODI and the differences of all indexes between pre- and post-operation were recorded and compared between the two groups. The neurological function was evaluated by Frankel scale.Results The operations of both groups were successfully completed. The operation time and intraoperative blood loss in group A were significant lower than those in group B (P<0.05). All incisions healed by first intetion. All patients were followed up 23-27 months (mean, 24.2 months) in group A and 24-28 months (mean, 24.8 months) in group B. At last follow-up, the VAS score, JOA score, ODI, Cobb angle, and SVA of the two groups were compared with those before operation, and the differences were significant (P<0.05). There was no significant difference between the two groups (P>0.05) in the indexes at last follow-up and the difference between pre- and post-operation. The lower extremity neurological symptoms (Frankel grade D) in 3 patients of group A before operation relieved (Frankel grade E) at last follow-up. The other patients were Frankel grade E. At last follow-up, CT showed bony fusion in the grafted area without any complications such as failure of internal fixation or pseudarthrosis.Conclusion For patients with old thoracolumbar compression fractures, the limited middle and posterior column osteotomy via transvertebral space approach has a satisfactory effectiveness. Compared with PSO, it can reduce surgical trauma on the basis of achieving the same degree of deformity correction.

Citation： MA Zheng, DING Wenyuan, JIAO Jianbao, CHEN Taoping, QIAN Ligang, CHEN Kang. Effectiveness of limited middle and posterior column osteotomy via transvertebral space approach for old thoracolumbar compression fracture. Chinese Journal of Reparative and Reconstructive Surgery, 2021, 35(7): 868-872. doi: 10.7507/1002-1892.202102027 Copy

1.	Chou D, Wang VY, Storm PB. Pedicle subtraction osteotomies for the correction of post-traumatic thoracolumbar kyphosis. J Clin Neurosci, 2010, 17(1): 113-117.
2.	Suzuki N, Ogikubo O, Hansson T. The prognosis for pain, disability, activities of daily living and quality of life after an acute osteoporotic vertebral body fracture: its relation to fracture level, type of fracture and grade of fracture deformation. Eur Spine J, 2009, 18(1): 77-88.
3.	Rajasekaran S, Kanna RM, Shetty AP. Management of thoracolumbar spine trauma: An overview. Indian J Orthop, 2015, 49(1): 72-82.
4.	Kim YJ, Bridwell KH, Lenke LG, et al. Results of lumbar pedicle subtraction osteotomies for fixed sagittal imbalance: a minimum 5-year follow-up study. Spine (Phila Pa 1976), 2007, 32(20): 2189-2197.
5.	Sasani M, Ozer AF. Single-stage posterior corpectomy and expandable cage placement for treatment of thoracic or lumbar burst fractures. Spine (Phila Pa 1976), 2009, 34(1): E33-E40.
6.	张锴, 高延征, 邢帅, 等. 改良后路单侧椎体次全切截骨矫形术治疗陈旧性胸腰椎骨折伴后凸畸形. 中华创伤杂志, 2019, 35(8): 708-715.
7.	路闯, 李辉, 祝文钢, 等. 后路选择性全脊椎截骨术治疗胸腰椎陈旧性骨折伴后凸畸形. 中国矫形外科杂志, 2018, 26(17): 1627-1629.
8.	Galibert P, Deramond H, Rosat P, et al. Preliminary note on the treatment of vertebral angioma by percutaneous acrylic vertebroplasty. Neurochirurgie, 1987, 33(2): 166-168.
9.	Demirkiran G, Dede O, Karadeniz E, et al. Anterior and posterior vertebral column resection versus posterior-only technique: a comparison of clinical outcomes and complications in congenital kyphoscoliosis. Clin Spine Surg, 2017, 30(7): 285-290.
10.	Lenke LG, O’Leary PT, Bridwell KH, et al. Posterior vertebral column resection for severe pediatric deformity: minimum two-year follow-up of thirty-five consecutive patients. Spine (Phila Pa 1976), 2009, 34(20): 2213-2221.
11.	王琨, 杨操, 杨述华, 等. 陈旧性胸腰椎骨折伴后凸畸形的截骨矫形术式选择. 中国脊柱脊髓杂志, 2016, 26(1): 24-29.
12.	乔木, 钱邦平, 邱勇, 等. 顶椎远端截骨治疗强直性脊柱炎胸腰椎后凸畸形. 中国脊柱脊髓杂志, 2019, 29(10): 868-874.
13.	莫凌, 梁德, 黄锦菁, 等. 基于 CT 多平面重建及 MRI 分析新鲜骨质疏松性椎体压缩骨折椎体内骨折区域形态类型及分布规律. 中国组织工程研究, 2020, 24(11): 1647-1653.
14.	苏启航, 张锦飙, 李聪, 等. 脊柱胸腰段骨折椎体的三维形态学分析. 骨科, 2019, 10(5): 379-383.
15.	Takenaka S, Mukai Y, Hosono N, et al. Major surgical treatment of osteoporotic vertebral fractures in the elderly: a comparison of anterior spinal fusion, anterior-posterior combined surgery and posterior closing wedge osteotomy. Asian Spine J, 2014, 8(3): 322-330.

1. Chou D, Wang VY, Storm PB. Pedicle subtraction osteotomies for the correction of post-traumatic thoracolumbar kyphosis. J Clin Neurosci, 2010, 17(1): 113-117.
2. Suzuki N, Ogikubo O, Hansson T. The prognosis for pain, disability, activities of daily living and quality of life after an acute osteoporotic vertebral body fracture: its relation to fracture level, type of fracture and grade of fracture deformation. Eur Spine J, 2009, 18(1): 77-88.
3. Rajasekaran S, Kanna RM, Shetty AP. Management of thoracolumbar spine trauma: An overview. Indian J Orthop, 2015, 49(1): 72-82.
4. Kim YJ, Bridwell KH, Lenke LG, et al. Results of lumbar pedicle subtraction osteotomies for fixed sagittal imbalance: a minimum 5-year follow-up study. Spine (Phila Pa 1976), 2007, 32(20): 2189-2197.
5. Sasani M, Ozer AF. Single-stage posterior corpectomy and expandable cage placement for treatment of thoracic or lumbar burst fractures. Spine (Phila Pa 1976), 2009, 34(1): E33-E40.
6. 张锴, 高延征, 邢帅, 等. 改良后路单侧椎体次全切截骨矫形术治疗陈旧性胸腰椎骨折伴后凸畸形. 中华创伤杂志, 2019, 35(8): 708-715.
7. 路闯, 李辉, 祝文钢, 等. 后路选择性全脊椎截骨术治疗胸腰椎陈旧性骨折伴后凸畸形. 中国矫形外科杂志, 2018, 26(17): 1627-1629.
8. Galibert P, Deramond H, Rosat P, et al. Preliminary note on the treatment of vertebral angioma by percutaneous acrylic vertebroplasty. Neurochirurgie, 1987, 33(2): 166-168.
9. Demirkiran G, Dede O, Karadeniz E, et al. Anterior and posterior vertebral column resection versus posterior-only technique: a comparison of clinical outcomes and complications in congenital kyphoscoliosis. Clin Spine Surg, 2017, 30(7): 285-290.
10. Lenke LG, O’Leary PT, Bridwell KH, et al. Posterior vertebral column resection for severe pediatric deformity: minimum two-year follow-up of thirty-five consecutive patients. Spine (Phila Pa 1976), 2009, 34(20): 2213-2221.
11. 王琨, 杨操, 杨述华, 等. 陈旧性胸腰椎骨折伴后凸畸形的截骨矫形术式选择. 中国脊柱脊髓杂志, 2016, 26(1): 24-29.
12. 乔木, 钱邦平, 邱勇, 等. 顶椎远端截骨治疗强直性脊柱炎胸腰椎后凸畸形. 中国脊柱脊髓杂志, 2019, 29(10): 868-874.
13. 莫凌, 梁德, 黄锦菁, 等. 基于 CT 多平面重建及 MRI 分析新鲜骨质疏松性椎体压缩骨折椎体内骨折区域形态类型及分布规律. 中国组织工程研究, 2020, 24(11): 1647-1653.
14. 苏启航, 张锦飙, 李聪, 等. 脊柱胸腰段骨折椎体的三维形态学分析. 骨科, 2019, 10(5): 379-383.
15. Takenaka S, Mukai Y, Hosono N, et al. Major surgical treatment of osteoporotic vertebral fractures in the elderly: a comparison of anterior spinal fusion, anterior-posterior combined surgery and posterior closing wedge osteotomy. Asian Spine J, 2014, 8(3): 322-330.

Chinese Journal of Reparative and Reconstructive Surgery

Effectiveness of limited middle and posterior column osteotomy via transvertebral space approach for old thoracolumbar compression fracture

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content