Nonunion Of Osteoporotic Vertebral Compression Fractures: Pathogenesis, Diagnosis And Treatment

Objective To explore the pathogenesis, clinical and imaging characteristics, diagnosis standard and treatment opinions of nonunion of osteoporotic vertebral compression fractures.Methods The records of 17 painful osteoporotic vertebral fractures in 14 patients which were treated by vertebroplasty or kyphoplasty in our department were reviewed from October 2001 to October 2007. There were 4 males and 10 females, with the average age of 68.3 years (range from 44 to 83). We determined the occurrence and location of these nonunion osteoporotic vertebral compression fractures, assessed the sensitivity of MR imaging and conventional radiography in the detection of these clefts and evaluated the effect of vertebroplasty by measuring the back pain at preoperative, postoperative and followed-up time.Results Nonunion of osteoporotic vertebral compression fractures were more common in T12, L1. Clefts were detected on preoperative MR images in 88.2% of the nonunion fractures, relatively in 64.7% on conventional radiography. Pain score measured by visual analog scale reduced from 8.7 to 1.7. There was a significant defference in pain score between preoperation and postoperation (t=17.85,P<0.05).Conclusion Nonunion of osteoporotic vertebral compression fractures was induced by series of factors. The diagnosis of the fracture nonunion mainly depends on clinical situation and imaging characteristics. Vertebroplasty is a safe and effective mini-invasive surgery for the fracture nonunion.