Surgical Treatment of Osteoporotic Spine Fracture with Neurological Deficits-Posterolateral Decompression and Posterior Reconstruction

INTRODUCTION: Osteoporosis is the most common cause of spinal compression fracture. Delayed vertebral collapse can occur in patients with osteoporotic spine fracture. This delayed vertebral collapse after osteoporotic spine fracture can cause progressive kyphosis and neurological deficits. The purpose of this study was to assess the results of posterolateral decompression and posterior reconstruction in patients with osteoporotic spine fracture with neurological deficits.

METHODS: Fourteen consecutive delayed vertebral collapse patients after osteoporotic spine fracture with neurological deficits who underwent posterolateral decompression and posterior reconstruction were included in this prospective study. Operation time, amount of blood loss, preoperative, postoperative and final follow-up kyphotic angle were assessed. Clinical outcomes were evaluated by pain score by VAS and neurological status by Frankel grades. Fusion was evaluated by flexion and extension plain radiographs.

RESULTS: Mean operation time was 217 minutes, mean blood loss was 682 ml. Mean segmental kyphotic angle was 22.6 degrees, preoperatively, and 4.4 degrees, postoperatively, and 6.8 degrees at the final follow-up. Bony fusion was obtained by 9 months after surgery. Pain score was 9.5 preoperatively and 2.7 postoperatively. In regards to the neurological status, seven patients each were evaluated as Frankel grade C and D preoperatively. Postoperatively two patients were Frankel grade D and the remaining twelve were Frankel grade E.

CONCLUSIONS: Based on the results of this study, posterolateral decompression and posterior reconstruction is a useful treatment option for osteoporotic spine fracture with neurological deficits.