Radiological Evaluation of Combined Anteroposterior Fusion with Vertebral Body Replacement Using a Minimally Invasive Lateral Approach for Osteoporotic Vertebral Fractures: Verification of Optimal Surgical Procedure
The combined anteroposterior fusion with vertebral body replacement (VBR) using a wide footplate expandable cage with a minimally invasive lateral approach has been widely used for pseudoarthrosis after osteoporotic vertebral fractures. The purpose of this study is to evaluate the radiological resul...
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| Format: | Article |
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MDPI AG
2022-01-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/3/629 |
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| author | Takumi Takeuchi Kenichiro Yamagishi Kazumasa Konishi Hideto Sano Masato Takahashi Shoichi Ichimura Hitoshi Kono Masaichi Hasegawa Naobumi Hosogane |
| author_facet | Takumi Takeuchi Kenichiro Yamagishi Kazumasa Konishi Hideto Sano Masato Takahashi Shoichi Ichimura Hitoshi Kono Masaichi Hasegawa Naobumi Hosogane |
| author_sort | Takumi Takeuchi |
| collection | DOAJ |
| description | The combined anteroposterior fusion with vertebral body replacement (VBR) using a wide footplate expandable cage with a minimally invasive lateral approach has been widely used for pseudoarthrosis after osteoporotic vertebral fractures. The purpose of this study is to evaluate the radiological results of combined anteroposterior surgery using VBR and to recommend the optimal procedure. Thirty-eight elderly patients were included in this study. The mean preoperative local kyphosis angle was 29.3°, and the mean correction loss angle was 6.3°. Cage subsidence was observed in ten patients (26.3%), and UIV or LIV fracture in twelve patients (31.6%). Patients with cage subsidence were compared to those without cage subsidence to determine the causal factors. The mean number of fixed vertebrae was 5.4 vertebrae with cage subsidence and 7.4 vertebrae without cage subsidence. In addition, to precisely clarify the optimal number of fixed vertebrae, those patients with two above–two below fixation were compared to those with less than two above–two below fixation, which revealed that the correction loss angle was significantly less in two above–two below fixation (<i>p</i> = 0.016). Based on these results, we recommend at least two above–two below fixation with VBR to minimize the correction loss angle and prevent cage subsidence. |
| first_indexed | 2024-03-09T23:41:55Z |
| format | Article |
| id | doaj.art-76f4049923cb4caf84fa363a7b379d26 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T23:41:55Z |
| publishDate | 2022-01-01 |
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| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-76f4049923cb4caf84fa363a7b379d262023-11-23T16:51:32ZengMDPI AGJournal of Clinical Medicine2077-03832022-01-0111362910.3390/jcm11030629Radiological Evaluation of Combined Anteroposterior Fusion with Vertebral Body Replacement Using a Minimally Invasive Lateral Approach for Osteoporotic Vertebral Fractures: Verification of Optimal Surgical ProcedureTakumi Takeuchi0Kenichiro Yamagishi1Kazumasa Konishi2Hideto Sano3Masato Takahashi4Shoichi Ichimura5Hitoshi Kono6Masaichi Hasegawa7Naobumi Hosogane8Department of Orthopedic Surgery, Kyorin University, Tokyo 181-8611, JapanDepartment of Orthopedic Surgery, Higashiyamato Hospital, Tokyo 207-0014, JapanDepartment of Orthopedic Surgery, Kyorin University, Tokyo 181-8611, JapanDepartment of Orthopedic Surgery, Kyorin University, Tokyo 181-8611, JapanDepartment of Orthopedic Surgery, Kyorin University, Tokyo 181-8611, JapanDepartment of Orthopedic Surgery, Kyorin University, Tokyo 181-8611, JapanDepartment of Orthopedic Surgery, Keiyu Orthopedic Hospital, Tatebayashi 374-0013, JapanDepartment of Orthopedic Surgery, Kugayama Hospital, Tokyo 157-0061, JapanDepartment of Orthopedic Surgery, Kyorin University, Tokyo 181-8611, JapanThe combined anteroposterior fusion with vertebral body replacement (VBR) using a wide footplate expandable cage with a minimally invasive lateral approach has been widely used for pseudoarthrosis after osteoporotic vertebral fractures. The purpose of this study is to evaluate the radiological results of combined anteroposterior surgery using VBR and to recommend the optimal procedure. Thirty-eight elderly patients were included in this study. The mean preoperative local kyphosis angle was 29.3°, and the mean correction loss angle was 6.3°. Cage subsidence was observed in ten patients (26.3%), and UIV or LIV fracture in twelve patients (31.6%). Patients with cage subsidence were compared to those without cage subsidence to determine the causal factors. The mean number of fixed vertebrae was 5.4 vertebrae with cage subsidence and 7.4 vertebrae without cage subsidence. In addition, to precisely clarify the optimal number of fixed vertebrae, those patients with two above–two below fixation were compared to those with less than two above–two below fixation, which revealed that the correction loss angle was significantly less in two above–two below fixation (<i>p</i> = 0.016). Based on these results, we recommend at least two above–two below fixation with VBR to minimize the correction loss angle and prevent cage subsidence.https://www.mdpi.com/2077-0383/11/3/629minimally invasive spinal treatment (MIST)osteoporotic vertebral body fracture (OVF)combined anteroposterior fusionvertebral body replacement (VBR)wide footplate expandable cagepercutaneous pedicle screws (PPS) |
| spellingShingle | Takumi Takeuchi Kenichiro Yamagishi Kazumasa Konishi Hideto Sano Masato Takahashi Shoichi Ichimura Hitoshi Kono Masaichi Hasegawa Naobumi Hosogane Radiological Evaluation of Combined Anteroposterior Fusion with Vertebral Body Replacement Using a Minimally Invasive Lateral Approach for Osteoporotic Vertebral Fractures: Verification of Optimal Surgical Procedure Journal of Clinical Medicine minimally invasive spinal treatment (MIST) osteoporotic vertebral body fracture (OVF) combined anteroposterior fusion vertebral body replacement (VBR) wide footplate expandable cage percutaneous pedicle screws (PPS) |
| title | Radiological Evaluation of Combined Anteroposterior Fusion with Vertebral Body Replacement Using a Minimally Invasive Lateral Approach for Osteoporotic Vertebral Fractures: Verification of Optimal Surgical Procedure |
| title_full | Radiological Evaluation of Combined Anteroposterior Fusion with Vertebral Body Replacement Using a Minimally Invasive Lateral Approach for Osteoporotic Vertebral Fractures: Verification of Optimal Surgical Procedure |
| title_fullStr | Radiological Evaluation of Combined Anteroposterior Fusion with Vertebral Body Replacement Using a Minimally Invasive Lateral Approach for Osteoporotic Vertebral Fractures: Verification of Optimal Surgical Procedure |
| title_full_unstemmed | Radiological Evaluation of Combined Anteroposterior Fusion with Vertebral Body Replacement Using a Minimally Invasive Lateral Approach for Osteoporotic Vertebral Fractures: Verification of Optimal Surgical Procedure |
| title_short | Radiological Evaluation of Combined Anteroposterior Fusion with Vertebral Body Replacement Using a Minimally Invasive Lateral Approach for Osteoporotic Vertebral Fractures: Verification of Optimal Surgical Procedure |
| title_sort | radiological evaluation of combined anteroposterior fusion with vertebral body replacement using a minimally invasive lateral approach for osteoporotic vertebral fractures verification of optimal surgical procedure |
| topic | minimally invasive spinal treatment (MIST) osteoporotic vertebral body fracture (OVF) combined anteroposterior fusion vertebral body replacement (VBR) wide footplate expandable cage percutaneous pedicle screws (PPS) |
| url | https://www.mdpi.com/2077-0383/11/3/629 |
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