Analysis for Etiology of Correction Loss after Surgical Treatment of Osteoporotic Vertebral Fracture with Neurologic Deficits

Whoan Jeang Kim; Jong Won Kang; Hwan Il Sung; Jae Guk Park; Kun Young Park; Sung Il Kang; Won Sik Choy

doi:10.4184/jkss.2007.14.4.243

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Kim, Kang, Sung, Park, Park, Kang, and Choy: Analysis for Etiology of Correction Loss after Surgical Treatment of Osteoporotic Vertebral Fracture with Neurologic Deficits

Original Article

Journal of Korean Spine Surg 2007;14(4):243-248.

Published online: 21 February 2007

DOI: https://doi.org/10.4184/jkss.2007.14.4.243

Analysis for Etiology of Correction Loss after Surgical Treatment of Osteoporotic Vertebral Fracture with Neurologic Deficits

Whoan Jeang Kim, M.D., Jong Won Kang, M.D., Hwan Il Sung, M.D., Jae Guk Park, M.D.^#, Kun Young Park, M.D.^$, Sung Il Kang, M.D., Won Sik Choy, M.D.

Department of Orthopaedic Surgery, Eulji University School of Medicine

^#Hong sung Medical Center

^$Daejon Veterans Hospital

Address reprint requests to Jong-Won Kang, M.D. Department of Orthopaedic Surgery, Eulji University School of Medicine, 1306, Dunsan-dong, Seo-gu Daejon, 302-799, Korea Tel: 82-42-611-3279, Fax: 82-42-259-1289, E-mail: jwkang@eulji.ac.kr

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Study Design

A retrospective radiologic study of 23 cases

Objectives

This study evaluated the etiology of correction loss after surgical treatment of osteoporotic vertebral fractures with neurologic deficits

Summary of Literature Review

osteoporotic vertebral fractures with neurologic deficits were treated with anterior decompression with posterior instrumentation or an Egg shell operation.

Materials and Methods

We experienced 23 cases treated surgically for osteoporotic vertebral fracture with neurologic deficits. In group A (16 cases), anterior decompression with posterior instrumentation were performed, with group B (7 cases) receiving an Egg shell operation. The kyphotic angle using Cobb's method and endplate injury were evaluated preoperatively, postoperatively, and at last follow up. Group A was subdivided into A1 and A2 according to preoperative and postoperative kyphotic angle, as well as being divided by endplate injury into subgroup a and b. Overcorrection of preoperative kyphotic angles were performed in A1, and undercorrection in A2 group, with endplate injury in subgroup a.

Results

Postoperative correction was 13.4。±3.4。 and correction loss was 9.68。±8.05。 in group A, and 21.5。±5.0。 and 8.0。±1.73。 in group B, respectively. Correction loss of group A1 (13.4。±8.8。) was significantly larger than A2 (4.71。±3.14。) (p=0.011). The correction loss of group A1a (18.0。±9.3。) was significantly larger than group A2 (8.5。±3.1。) (p=0.050) and A2a (p=0.036). The correction loss of group A1b was significantly larger than group A2b (p=0.029), and correction losses were not significantly different in A2a (6.0。±4.0。) and A2b (3.25。±1.7。) (p=0.289).

Conclusions

Less Correction loss was found in the undercorrection and non-endplate injury group

Keywords: Osteoporosis, Correction loss, Vertebral fracture, Extension lateral radiography, Surgical treatment

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Fig. 1.

Cobb's angle of adjacent level in lateral spine radiography. (A) pre-op lateral, (B) pre-op lateral extension, (C) (D) intra-op lateral with kyphosis correction.

Fig. 2.

Average values of kyphosis correction and correction loss (percentage) between Group A and B.

Fig. 3.

Average values of kyphosis correction loss between A1 and A2

Fig. 4.

Average values of kyphosis correction loss of Group A1 and A2 according to endplate injury

Fig. 5.

Average values of kyphosis correction loss of subgroup a and b according to kyphosis correction.

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