Multiple Posterior Lumbar Interbody Fusion And Posterolateral Fusion Instrumentation For Thoracolumbar Kyphosis And Osteoporotic Fracture In Older Adults

Background: China's population is aging fast.The incidence rate of osteoporosis fracture with thoracolumbar kyphosis is increasing.Whether or not a corrective osteotomy is required still remains a controversy.The clinical outcome of multiple PLIF and PLF treating the thoracolumbar kyphosis in old patients with osteoporosis is still uncertain.Objective: To evaluate changes in spinal alignment and QOL after multiple posterior lumber interbody fusion(PLIF)and posterolateral fusion(PLF)instrumentation for patients with osteoporosis fracture with thoracolumbar kyphosis.To compare clinical and radiological results between the surgical group and non-operated osteoporotic patients without thoracolumbar fracture.Methods: The operation group included 40 patients(67±7.5ys)with osteoporosis who underwent corrective spinal surgery using multilevel PLIF for symptomatic thoracolumbar kyphosis.The non-operation control group included 50patients(64±8.3ys)of osteoporosis without kyphosis.The ODI score and VAS score were compared between two groups.Spinoplevic parameters such as TKA,LLA,SVA,PT and PI was evaluated with standing lateral spine radiography preoperatively and postoperatively.The quality of life was evaluated with the JapaneseOsteoporosis QOL Questionnaire(JOQOL).Results and Conclusion: The VAS score and ODI scores of surgical group were improved significantly.The thoracic and lumbar Cobb angle were significantly improved postoperatively.TKA,SVA and PT were significantly improved postoperatively.The JOQOL score was significant improved,especially in the subscale scores for pain and general/mental health.The results indicate that spinal alignment and JOQOL were significantly improved after corrective spinal surgery using multilevel PLIF and PLF for patients with osteoporosis and thoracolumbar or lumbar kyphosis.