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Abstract
Study design
Retrospective analysis of surgical treatment in patients with osteoporotic vertebral fracture associated myelopathy.
Objectives
To evaulate the clinical outcome of anterior decompression and fusion for osteoporotic vertebral fracture associated with myelopathy.
Summary of Literature Review
Major treatment of osteoporotic vertebral fracture were conservative methods. In patients with myelopathy, surgical treatment is recommanded.
Materials and Methods
From January 1995 to December 1998, twelve patients who had osteoporotic vertebral fracture associated with myelopathy and treated by operation were evaluated retrospectively. With simple roentgenography and dual energy absorptiometry, osteoporosis was evaluated. A nd with MRI and nerve conduction velocity test, we could diagnosed myelopathy. In ten patients, anterior approach was used, and in two patients, posterior approach was used.
Results
In all patients after operation, the neurologic symptoms according to the Frankel grading scale were improved over one grade and followup X - ray showed bone union finding unrelated to the site, shape, and severity of fracture. No significant complications such as increasing of kyphotic angle and metal loosening were existed in all cases.
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Figures and Tables%
 | Fig. 1.66-year-old female. She was treated with T12 anterior decompression and T11-L1 anterior interbody fusion. Fig. 1-A. Preoperative X-ray shows severe compression fracture of T12 vertebral body. Fig. 1-B. Preoperative MRI shows compression of T12 spinal cord. Fig. 1-C. Immediate postoperative X-ray shows autogenous bone graft and plate and screws fixation state. Fig. 1-D. Postoperative one year X-ray shows well maintained state of plate and screws, and bone union of graft site. |
Table 1.
Results of preoperative evaluation and operation methods in osteoporotic vertebral fracture with myelopathy.
| Patient (Age/Sex) | Fracture site | Saville grade | Type of deformity | Spinal central score(Barnett) | Bone density* | Myelopathy (MRI†/NCV‡) | Kyphotic change(X-ray) | operation methods |
|---|---|---|---|---|---|---|---|---|
| 1(68/M) | T9 | III | Flat | 38 | 0.504 | +/+ | – | ant. decomp.§ |
| 2(70/F) | T10 | IV | Flat | 27 | 0.372 | +/+ | – | ant. decomp. |
| 3(58/F) | T12 | II | Biconcave | 42 | 0.497 | +/+ | – | ant. decomp. |
| 4(65/F) | T9 | III | Biconcave | 48 | 0.582 | +/+ | – | ant. decomp. |
| 5(64/F) | T9 | II | Flat | 32 | 0.571 | +/+ | – | ant. decomp. |
| 6(78/M) | T11 | II | Wedge | 63 | 0.729 | +/+ | + | post. decomp.|| |
| 7(72/F) | T1 | III | Flat | 41 | 0.425 | +/+ | – | ant. decomp. |
| 8(70/M) | T9 | IV | Flat | 37 | 0.397 | +/+ | – | ant. decomp. |
| 9(76/F) | L1 | IV | Biconcave | 50 | 0.492 | +/+ | + | post. decomp. |
| 10(66/F) | T12 | IV | Flat | 41 | 0.489 | +/+ | – | ant. decomp. |
| 11(69/M) | T12 | IV | Biconcave | 44 | 0.501 | +/+ | – | ant. decomp. |
| 12(66/F) | T10 | II | Biconcave | 50 | 0.577 | +/+ | – | ant. decomp. |
| mean 68.6 | 42.8 | 0.511 | ||||||
| Bone density* : bone density measured by dual energy absorptiometry | ||||||||
| MRI† : magnetic resonance imaging | ||||||||
| NCV‡ : nerve conduction velocity | ||||||||
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