Treatment Of The Osteoporotic Vertebral Compression Fractures With Kyphotic Deformity In One-stage Posterior Half Vertebral Column Resection Through Unilateral Approach

Objective: To explore the one-stage posterior vertebral unilateral column resection(PUVCR)through unilateral approach for the treatment of senile obsolete vertebral compression fracture with kyphotic deformity.Methods: From Feb.2010 to Jun 2013;26 cases of the senile obsolete vertebral compression fracture with kyphotic deformity were treated in the third hospital of Hebei Medical University and enrolled in this study,the average age was 68.8years(63-75 years),fourteen males and twelve females.12 patients(2012.6~2014.6)received PUVCR the preoperative kyphotic angle was 45.6°±6.7°.14 patients(2010.2~2012.6)received posterior vertebral column resection(PVCR)as control group,the preoperative kyphotic angle was 48.4° ± 7.2°.The clinical records were reviewed and compared for operating time,operative and postoperative blood loss,correction of kyphotic deformity,functional improvement(Oswestry disability index,ODI),pain(visual analog scale,VAS)and complications.Results: The operation time,intraoperative blood loss and postoperative drainage in the PUVCR groups were significantly less than in the PVCR group(P<0.05).There was no difference between PVCR and PHVCR groups in terms of correction of kyphotic angle postoperatively,loss of correction in one-year follow up.improvement of ODI and decrease of VAS in one-year follow up(P> 0.05).The rate of intraoperative unintentional impingement was 16.7%(2/12)in PVCR group and none in PUVCR group.All patients in two groups achieved bony fusion and no one has screw loosen or titanium mesh transposition in one-year follow up.Conclusions: Compared with the PVCR,in the treatment of the senile obsolete vertebral compression fracture with kyphotic deformity,Our PUVCR can achieve similar correction of sagittal deformity,neural functional improvement and pain relief,and has advantages of shorter operation time,reduced blood loss.it can effectively reduce perioperative complications and provide a higher rate of bone graft fusion and stability...