Role of Major Spine Surgery Using Kaneda Anterior Instrumentation for Osteoporotic Vertebral Collapse
| Autor: | Daisuke Togawa, Fumihiro Oha, Kiyoshi Kaneda, Tomoyuki Hashimoto, Masahiro Kanayama, Takashi Ishida, Keiichi Shigenobu |
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| Rok vydání: | 2010 |
| Předmět: |
Male
Ceramics medicine.medical_specialty Visual analogue scale Decompression Radiography Kyphosis Biocompatible Materials Prosthesis Design medicine Humans Orthopedics and Sports Medicine Aged Retrospective Studies Titanium Vertebroplasty Bone Transplantation business.industry Retrospective cohort study Prostheses and Implants Plastic Surgery Procedures Decompression Surgical medicine.disease Low back pain Internal Fixators Spine Surgery Spinal Fusion Treatment Outcome Osteoporosis Spinal Fractures Female Neurology (clinical) medicine.symptom business Anterior instrumentation Osteoporotic vertebral collapse |
| Zdroj: | Journal of Spinal Disorders & Techniques. 23:53-56 |
| ISSN: | 1536-0652 |
| DOI: | 10.1097/bsd.0b013e318193e3a5 |
| Popis: | Study design A retrospective study. Objectives To investigate the clinical and radiographic results of spinal reconstruction using Kaneda anterior spinal instrumentation for osteoporotic vertebral collapse. Summary of background data Recent advances in osteoporotic vertebral fracture treatment including kyphoplasty changes the role of major surgery for these pathologies. However, osteoporotic vertebral collapse with neurologic compromise remains requiring surgical decompression and reconstruction. Methods Thirty-one consecutive patients who underwent anterior spinal reconstruction for osteoporotic vertebral collapse with neurologic deficits were reviewed retrospectively. Twenty-six patients had single vertebral collapse and 5 had multiple lesions. They were 10 males and 21 females with mean age of 71 years. Mean follow-up period was 57 months. For anterior column support, iliac bone graft was used in 1 patient, cylindrical titanium cages in 12, and bioactive ceramic spacers in 18 patients. Kaneda anterior instrumentation was used in all the patients. Radiographic and clinical assessments were performed preoperatively and at the final follow-up. Results All the patients showed neurologic recovery. Visual analog scales (0 to 10) of low back pain and sciatic pain were 5.8 and 4.2 before surgery, and 2.1 and 0.6 at the final follow-up, respectively. Mean kyphosis of operative levels was 31 degrees before surgery, and improved to 13 degrees immediately after surgery and 21 degrees at the final follow-up. Posterior reinforcement was required in 6 patients (19%), who had severe osteoporosis and/or underwent multilevel corpectomies. Solid fusion was achieved in all patients at the final follow-up. Conclusions The current study demonstrated the advantages of anterior spinal reconstruction in osteoporotic vertebral collapse: (1) safe and reliable decompression could be performed, and (2) 80% of patients were successfully treated with anterior spinal reconstruction alone. However, patients with multilevel corpectomies and/or severe osteoporosis highly required posterior reinforcement. |
| Databáze: | OpenAIRE |
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