Abstract
Introduction: A retrospective study of patients with vertebroplasty-treated osteoporotic compression fracture of the spine is presented. Material and Method: A total of 52 patients (43 women, 9 men) of an average age of 68.2 years, treated from 1/2010 to 12/2016 were included.
During the preoperative examination, a total of 109 fractures of various ages were found in the surgery group including 90 vertebrae. A total of 26 patients were diagnosed with one, 15 with two and 11 patients with three or more fractured vertebrae.
A total of 72 vertebrae were filled with monopedicular technique, the rest of 18 vertebrae were treated by bipedicular filling technique. Results: No serious clinical complications related to the vertebroplasty were observed acutely postoperatively, or at a follow-up interval of 1 year after surgery.
Functional clinical score (JOA), improvement was seen from a preoperative average of 14.4 to 15.7 at 1 year postoperatively. The postoperative pain assessment (VAS score) saw improvement from preoperative 7.1 to 3.3 postoperatively.
Restoring the sagittal balance by measuring the modified Cobb angle in the sagittal plane occurred from a preoperative mean of 17.9 to a postoperative improvement of 15.1 with subsequent loss of correction to 17.6 degrees at 1 year after surgery. Leakage of cement from the vertebral body was recorded in 32 treated vertebrae (35.6%).
There was no clinical complication related to escape of cement from the vertebra. Manifestation of a new pathological vertebral fracture in the annual observation interval adjacent to the operative vertebra was found in a total of 12 of the 90 operated vertebrae (13.3%).
Discussion: Compared with recent studies, the clinical effect of vertebroplasty and possible complications, especially leakage of cement from the vertebral body and fracture of the adjacent vertebra, are discussed. Furthermore, the possible effect of vertebroplasty on the correction of vertebral deformity and the effect on the sagittal balance of the spine are discussed.
Conclusion: The study demonstrated a good clinical effect of vertebroplasty in the treatment of osteoporotic compression fractures of the spine. The method is a choice in patients where conservative therapy has primarily failed.
Vertebroplasty does not allow correction of the deformity of the vertebral body and does not improve the sagittal profile of the patient. In the postoperative period, it is important to monitor the patient with a potential fracture of the adjacent vertebral fracture.