Cortical Bone Trajectory Instrumentation with Vertebroplasty for Osteoporotic Thoracolumbar Compression Fracture
Background: Osteoporotic spinal fractures commonly occur in elderly patients with low bone mineral density. In these cases, percutaneous vertebroplasty or percutaneous kyphoplasty can provide significant pain relief and improve mobility. However, studies have reported both the recurrence of vertebra...
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MDPI AG
2020-02-01
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| Online Access: | https://www.mdpi.com/1010-660X/56/2/82 |
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| author | Wei-Lin Hsu Yu-Hsiang Lin Hao-Yu Chuang Han-Chung Lee Der-Cherng Chen Yen-Tse Chu Der-Yang Cho Chao-Hsuan Chen |
| author_facet | Wei-Lin Hsu Yu-Hsiang Lin Hao-Yu Chuang Han-Chung Lee Der-Cherng Chen Yen-Tse Chu Der-Yang Cho Chao-Hsuan Chen |
| author_sort | Wei-Lin Hsu |
| collection | DOAJ |
| description | Background: Osteoporotic spinal fractures commonly occur in elderly patients with low bone mineral density. In these cases, percutaneous vertebroplasty or percutaneous kyphoplasty can provide significant pain relief and improve mobility. However, studies have reported both the recurrence of vertebral compression fractures at the index level after vertebroplasty and the development of new vertebral fractures at the adjacent level that occur without any additional trauma. Pedicle screw fixation combined with percutaneous vertebroplasty has been proposed as an effective procedure for addressing osteoporotic thoracolumbar fractures. However, in osteoporotic populations, pedicle screws can loosen, pullout, or migrate. Currently, the efficacy of cortical bone trajectory screw fixation for osteoporotic fractures remains unclear. Thus, we assessed the effects of using cortical bone trajectory instrumentation with vertebroplasty on patient outcomes. Method: We retrospectively reviewed data from 12 consecutively sampled osteoporotic thoracolumbar fracture patients who underwent cortical bone trajectory instrumentation with vertebroplasty. Patients were enrolled beginning in October 2015 and were followed for >24 months. Result: The average age was 74 years, and the average dual-energy x-ray absorptiometry T-score was −3.6. The average visual analog scale pain scores improved from 8 to 2.5 after surgery. The average blood loss was 36.25 mL. All patients regained ambulation and experienced reduced pain post-surgery. No recurrent fractures or instrument failures were recorded during follow-up. Conclusions: Our findings suggest that cortical bone trajectory instrumentation combined with percutaneous vertebroplasty may be a good option for treating osteoporotic thoracolumbar fractures, as it can prevent recurrent vertebral fractures or related kyphosis in sagittal alignment. |
| first_indexed | 2024-03-12T05:52:06Z |
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| last_indexed | 2024-03-12T05:52:06Z |
| publishDate | 2020-02-01 |
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| series | Medicina |
| spelling | doaj.art-10d78ca8ec5d4df797d2b531fdd1be3a2023-09-03T05:01:40ZengMDPI AGMedicina1010-660X2020-02-015628210.3390/medicina56020082medicina56020082Cortical Bone Trajectory Instrumentation with Vertebroplasty for Osteoporotic Thoracolumbar Compression FractureWei-Lin Hsu0Yu-Hsiang Lin1Hao-Yu Chuang2Han-Chung Lee3Der-Cherng Chen4Yen-Tse Chu5Der-Yang Cho6Chao-Hsuan Chen7Department of Neurosurgery, China Medical University Hospital, Taichung 404, TaiwanDepartment of Neurosurgery, China Medical University Hospital, Taichung 404, TaiwanDepartment of Neurosurgery, China Medical University Hospital, Taichung 404, TaiwanDepartment of Neurosurgery, China Medical University Hospital, Taichung 404, TaiwanDepartment of Neurosurgery, China Medical University Hospital, Taichung 404, TaiwanDepartment of Neurosurgery, China Medical University Hospital, Taichung 404, TaiwanDepartment of Neurosurgery, China Medical University Hospital, Taichung 404, TaiwanDepartment of Neurosurgery, China Medical University Hospital, Taichung 404, TaiwanBackground: Osteoporotic spinal fractures commonly occur in elderly patients with low bone mineral density. In these cases, percutaneous vertebroplasty or percutaneous kyphoplasty can provide significant pain relief and improve mobility. However, studies have reported both the recurrence of vertebral compression fractures at the index level after vertebroplasty and the development of new vertebral fractures at the adjacent level that occur without any additional trauma. Pedicle screw fixation combined with percutaneous vertebroplasty has been proposed as an effective procedure for addressing osteoporotic thoracolumbar fractures. However, in osteoporotic populations, pedicle screws can loosen, pullout, or migrate. Currently, the efficacy of cortical bone trajectory screw fixation for osteoporotic fractures remains unclear. Thus, we assessed the effects of using cortical bone trajectory instrumentation with vertebroplasty on patient outcomes. Method: We retrospectively reviewed data from 12 consecutively sampled osteoporotic thoracolumbar fracture patients who underwent cortical bone trajectory instrumentation with vertebroplasty. Patients were enrolled beginning in October 2015 and were followed for >24 months. Result: The average age was 74 years, and the average dual-energy x-ray absorptiometry T-score was −3.6. The average visual analog scale pain scores improved from 8 to 2.5 after surgery. The average blood loss was 36.25 mL. All patients regained ambulation and experienced reduced pain post-surgery. No recurrent fractures or instrument failures were recorded during follow-up. Conclusions: Our findings suggest that cortical bone trajectory instrumentation combined with percutaneous vertebroplasty may be a good option for treating osteoporotic thoracolumbar fractures, as it can prevent recurrent vertebral fractures or related kyphosis in sagittal alignment.https://www.mdpi.com/1010-660X/56/2/82cortical bone trajectoryosteoporosisvertebral compression fracturevertebroplasty |
| spellingShingle | Wei-Lin Hsu Yu-Hsiang Lin Hao-Yu Chuang Han-Chung Lee Der-Cherng Chen Yen-Tse Chu Der-Yang Cho Chao-Hsuan Chen Cortical Bone Trajectory Instrumentation with Vertebroplasty for Osteoporotic Thoracolumbar Compression Fracture Medicina cortical bone trajectory osteoporosis vertebral compression fracture vertebroplasty |
| title | Cortical Bone Trajectory Instrumentation with Vertebroplasty for Osteoporotic Thoracolumbar Compression Fracture |
| title_full | Cortical Bone Trajectory Instrumentation with Vertebroplasty for Osteoporotic Thoracolumbar Compression Fracture |
| title_fullStr | Cortical Bone Trajectory Instrumentation with Vertebroplasty for Osteoporotic Thoracolumbar Compression Fracture |
| title_full_unstemmed | Cortical Bone Trajectory Instrumentation with Vertebroplasty for Osteoporotic Thoracolumbar Compression Fracture |
| title_short | Cortical Bone Trajectory Instrumentation with Vertebroplasty for Osteoporotic Thoracolumbar Compression Fracture |
| title_sort | cortical bone trajectory instrumentation with vertebroplasty for osteoporotic thoracolumbar compression fracture |
| topic | cortical bone trajectory osteoporosis vertebral compression fracture vertebroplasty |
| url | https://www.mdpi.com/1010-660X/56/2/82 |
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