World neurosurgery · 2018
New Technology for Surgical Treatment of Osteoporotic Vertebral Compression Fractures: The Transvertebral Bone Graft and Fixation.
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Hou Yang, Shi Guodong, Sun Jingchuan, Shi Jiangang, Xu Guohua, Guo Yongfei, Han Dan
Аннотация
OBJECTIVE: To introduce an innovative surgical technique, transvertebral bone graft and augmentation (TBGA), to and evaluate its clinical efficacy in treating osteoporotic vertebral body compression fractures (VCFs), with balloon kyphoplasty (BKP) as a control.
METHODS: A total of 81 patients with a single-level osteoporotic VCF underwent TBGA (n = 38) or BKP (n = 43) at our hospital between October 2012 and January 2015. The average duration of follow-up period was 27.9 months. The patients were evaluated with plain radiography, computed tomography, and magnetic resonance imaging preoperatively, immediately postoperatively, at 3- and 6-month follow-ups, and every 6 months thereafter. Clinical status was assessed using the Oswestry Disability Index (ODI) and a visual analog scale (VAS). In addition, parameters of anterior vertebral body height (AVBH), kyphosis angle (KA), adjacent segment degeneration (ASD), and complications were also compared between the 2 groups.
RESULTS: Significant clinical improvements in ODI, VAS scores, AVBH, and KA were seen in both the TBGA and BKP groups after surgery (P < 0.05). However, the differences in improvements in ODI and VAS between the TBGA and BKP groups were not statistically significant (P > 0.05). The improvements in AVBH and KA were significantly better in the TBGA group (P < 0.05). Furthermore, the rates of ASD and complications were significantly lower in the TBGA group during the follow-up period (P < 0.05).
CONCLUSIONS: TBGA is an effective and safe surgical technique that appears to be a promising alternative to BKP for the surgical treatment of osteoporotic VCFs.
METHODS: A total of 81 patients with a single-level osteoporotic VCF underwent TBGA (n = 38) or BKP (n = 43) at our hospital between October 2012 and January 2015. The average duration of follow-up period was 27.9 months. The patients were evaluated with plain radiography, computed tomography, and magnetic resonance imaging preoperatively, immediately postoperatively, at 3- and 6-month follow-ups, and every 6 months thereafter. Clinical status was assessed using the Oswestry Disability Index (ODI) and a visual analog scale (VAS). In addition, parameters of anterior vertebral body height (AVBH), kyphosis angle (KA), adjacent segment degeneration (ASD), and complications were also compared between the 2 groups.
RESULTS: Significant clinical improvements in ODI, VAS scores, AVBH, and KA were seen in both the TBGA and BKP groups after surgery (P < 0.05). However, the differences in improvements in ODI and VAS between the TBGA and BKP groups were not statistically significant (P > 0.05). The improvements in AVBH and KA were significantly better in the TBGA group (P < 0.05). Furthermore, the rates of ASD and complications were significantly lower in the TBGA group during the follow-up period (P < 0.05).
CONCLUSIONS: TBGA is an effective and safe surgical technique that appears to be a promising alternative to BKP for the surgical treatment of osteoporotic VCFs.