| Objective To investigate the clinical efficacy of bone cement augmentation of pedicle screws for osteoporotic thoracolumbar fractures combined with kyphosis.Method From March 2013 to August 2016,52 patients with osteoporotic thoracolumbar fractures combined with kyphosis received bone cement augmentation of pedicle screws treatment.There were 10 males and 42 females with an average age of 70.5(range55-84)years old.The Cobb angle of kyphosis were measured by PACS software preopetativly,three months postoperativly,as well as the final follow-up.The thoracolumbar Visual Analogue Scale(VAS)and the Oswestry Disability Index(ODI)were evaluated preoperatively and postoperativly for life quality.The ASIA neurologic grading system was recorded to evaluate the neurological function.We collected the incidence of perioperative complications and bone cement related complications.Result A total of 52 patients underwent placement of 458 pedicle screws in 232 vertebraes,and 282 augmented screws(61.6%)were inserted in 146 vertebraes(62.9%).The mean amount of bone cement was(2.03±0.52)ml in thoracic nail and(2.43±0.88)ml in lumbar nail.The mean follow-up duration was 19.2(range3-56)months.The thoracolumbar VAS score decreased from perioperative(6.54±1.26)to the final follow-up(0.62±0.75);The ODI was(69.06±13.26)% before surgery,and was(20.74±5.91)% at the final follow-up;The correction of Cobb angle from(23.88±13.73)° to(11.07±8.96)°;There were significantly statistical differences(P<0.001)in all indexes between preoperation and postoperation.The ASIA neurologic grading system were C in 2 case,D in 5 case before surgery,and were D in 2 case,E in 5 cases at the final follow-up.one of 282 augmented of pedicle screws whose had cement leakage flowing inside of pedicle through damaged posterior wall,the patient’neurologic impairment didn’t exacerbated with intraoperative decompression in time.Eleven patients were found to have cement leakage into anterior vertebral body and thirteen patients occurred cement leakage into the vertebral disc,none of these twenty-four patients had neurological symptoms.None of these 458 pedicle screws was detected loosening or fracture.Conclusion Bone cement augmentation of pedicle screws for osteoporotic thoracolumbar fractures combined with kyphosis can not only improve the stability of the screw but also correcte the kyphosis deformity. |
