CLINICAL AND RADIOLOGICAL OUTCOMES OF THE SEVERE OSTEOPOROTIC VERTEBRAL COMPRESSION FRACTURES TREATED WITH VERTEBROPLASTY AND SHORT SEGMENT CEMENT AUGMENTED SCREW FIXATION

Ghanshyam Kakadiya; Deepak Joshi

doi:10.1302/1358-992X.2021.16.010

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CLINICAL AND RADIOLOGICAL OUTCOMES OF THE SEVERE OSTEOPOROTIC VERTEBRAL COMPRESSION FRACTURES TREATED WITH VERTEBROPLASTY AND SHORT SEGMENT CEMENT AUGMENTED SCREW FIXATION

The British Orthopaedic Research Society (BORS) Annual Meeting 2021, held online, 13–14 September 2021.

Ghanshyam Kakadiya
Deepak Joshi

CLINICAL AND RADIOLOGICAL OUTCOMES OF THE SEVERE OSTEOPOROTIC VERTEBRAL COMPRESSION FRACTURES TREATED WITH VERTEBROPLASTY AND SHORT SEGMENT CEMENT AUGMENTED SCREW FIXATION

Kakadiya G, Joshi D. CLINICAL AND RADIOLOGICAL OUTCOMES OF THE SEVERE OSTEOPOROTIC VERTEBRAL COMPRESSION FRACTURES TREATED WITH VERTEBROPLASTY AND SHORT SEGMENT CEMENT AUGMENTED SCREW FIXATION. Orthop Procs. 2021;103-B(SUPP_16):10-10. doi:10.1302/1358-992X.2021.16.010

Kakadiya, Ghanshyam, and Deepak Joshi. “CLINICAL AND RADIOLOGICAL OUTCOMES OF THE SEVERE OSTEOPOROTIC VERTEBRAL COMPRESSION FRACTURES TREATED WITH VERTEBROPLASTY AND SHORT SEGMENT CEMENT AUGMENTED SCREW FIXATION.” Orthopaedic Proceedings, vol. 103-B, no. SUPP_16, 2021, pp. 10-10., https://doi.org/10.1302/1358-992X.2021.16.010

Kakadiya, G., & Joshi, D. (2021). CLINICAL AND RADIOLOGICAL OUTCOMES OF THE SEVERE OSTEOPOROTIC VERTEBRAL COMPRESSION FRACTURES TREATED WITH VERTEBROPLASTY AND SHORT SEGMENT CEMENT AUGMENTED SCREW FIXATION. Orthopaedic Proceedings, 103-B(SUPP_16), 10-10. https://doi.org/10.1302/1358-992X.2021.16.010

Kakadiya, G. and Joshi, D. (2021) “CLINICAL AND RADIOLOGICAL OUTCOMES OF THE SEVERE OSTEOPOROTIC VERTEBRAL COMPRESSION FRACTURES TREATED WITH VERTEBROPLASTY AND SHORT SEGMENT CEMENT AUGMENTED SCREW FIXATION.” Orthopaedic Proceedings, 103-B(SUPP_16), pp. 10-10. Available at: https://doi.org/10.1302/1358-992X.2021.16.010

Kakadiya, Ghanshyam, and Deepak Joshi. “CLINICAL AND RADIOLOGICAL OUTCOMES OF THE SEVERE OSTEOPOROTIC VERTEBRAL COMPRESSION FRACTURES TREATED WITH VERTEBROPLASTY AND SHORT SEGMENT CEMENT AUGMENTED SCREW FIXATION.” Orthopaedic Proceedings 103-B, no. SUPP_16 (2021): 10-10. https://doi.org/10.1302/1358-992X.2021.16.010

Kakadiya G, Joshi D. CLINICAL AND RADIOLOGICAL OUTCOMES OF THE SEVERE OSTEOPOROTIC VERTEBRAL COMPRESSION FRACTURES TREATED WITH VERTEBROPLASTY AND SHORT SEGMENT CEMENT AUGMENTED SCREW FIXATION. Orthop Procs. 2021 Dec 1;103-B(SUPP_16):10-10. https://doi.org/10.1302/1358-992X.2021.16.010

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Abstract

Objectives

The principle of osteoporotic vertebral compression fracture (OVCF) is fixing instability, providing anterior support, and decompression. Contraindication for vertebroplasty is anterior or posterior wall fracture. The study objectives was to evaluate the efficacy and safety of vertebroplasty with short segmented PMMA cement augmented pedicle screws for OVCF with posterior/anterior wall fracture patients.

Methods

A retrospective study of 24 patients of DGOU type-4 (vertebra plana) OVCF with posterior/anterior wall fracture, were treated by vertebroplasty and short segment PMMA cement augmented pedicle screws fixation. Radiological parameters (kyphosis angle and compression ratio) and clinical parameters Visual analogue scale (VAS) and Oswestry disability index (ODI) were analysed.

Results

A significant improvement was noted in VAS (preoperative, 7.90 ±0.60; final follow-up 2.90 ± 0.54) and ODI (77.10 ± 6.96 to 21.30 ± 6.70), (P < 0.05). Neurological improvement was noted in all patients. Kyphosis corrected significantly from preoperative 23.20±5.90 to 5.30±1.40 postoperative with 5% (3.30± 2.95) loss of correction at final follow-up. Anterior vertebral height restored significantly from 55.80±11.9% t0 87.6±13.1% postoperative with 4.5±4.0% loss at final follow-up. One case had cement leakage was found, but the patient is asymptomatic. No implant-related complication was seen. No iatrogenic dural or nerve injury.

Conclusions

Treatment with vertebroplasty with cement augmented screw fixation and direct decompression is a great option in treating such a complex situation in fragile age with fragile bones because It provides anterior support with cementing that avoids corpectomy. Short segment fixation has less stress risers at the junctional area.