Is Decompression Necessary with Posterior Spinal Fusion for Osteoporotic Vertebral Fractures with Delayed Neurological Deficit?

DOI
  • Uehara Masashi
    Department of Orthopaedic Surgery, Shinshu University School of Medicine
  • Futatsugi Toshimasa
    Department of Orthopaedic Surgery, Marunouchi Hospital
  • Ikegami Shota
    Department of Orthopaedic Surgery, Shinshu University School of Medicine
  • Kuraishi Shugo
    Department of Orthopaedic Surgery, Shinshu University School of Medicine
  • Oba Hiroki
    Department of Orthopaedic Surgery, Shinshu University School of Medicine
  • Takizawa Takashi
    Department of Orthopaedic Surgery, Shinshu University School of Medicine
  • Munakata Ryo
    Department of Orthopaedic Surgery, Shinshu University School of Medicine
  • Hatakenaka Terue
    Department of Orthopaedic Surgery, Shinshu University School of Medicine
  • Kamanaka Takayuki
    Department of Orthopaedic Surgery, Shinshu University School of Medicine
  • Miyaoka Yoshinari
    Department of Orthopaedic Surgery, Shinshu University School of Medicine
  • Mimura Tetsuhiko
    Department of Orthopaedic Surgery, Shinshu University School of Medicine
  • Takahashi Jun
    Department of Orthopaedic Surgery, Shinshu University School of Medicine

Bibliographic Information

Other Title
  • 遅発性神経障害（脊髄～円錐部）を伴う骨粗鬆症性椎体骨折の後方固定術に除圧併用は必要なのか？

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Abstract

<p>Introduction: In patients with osteoporotic vertebral fractures (OVF) resulting in neurological deficit, it is controversial whether decompression should be added to posterior spinal fusion. The purpose of this study was to examine the necessity of concomitant decompression and spinal fusion surgery in OVF with delayed neurological deficit.</p><p>Methods: Twenty-one patients who underwent posterior spinal fusion for OVF with delayed neurological deficit between 2011 and 2018 were retrospectively examined. Surgical invasiveness, complications, and postoperative outcomes were compared between the decompression group (n=10) in which decompression was added to fixation and the non-decompression group (n=11) with fixation alone.</p><p>Results: There were no significant differences for age or gender between the groups, and preoperative cross-dural canal area and fragment occupancy rate were comparable. Operative time was significantly longer in the decompression group at 227 minutes versus 151 minutes in the non-decompression group (P=0.02). Bleeding volume was 325 ml in the decompression group and 260 ml in the non-decompression group, a nonsignificant difference (P=0.26). Postoperatively, Frankel classification improved to D2 or better in all patients of both groups.</p><p>Conclusions: In posterior fixation for OVF with delayed neurological deficit, the addition of decompression to posterior spinal fusion was not associated with remarkably improved recovery of neurological symptoms.</p>

Journal

  • Journal of Spine Research

    Journal of Spine Research 12 (9), 1181-1187, 2021-09-20

    The Japanese Society for Spine Surgery and Related Research

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