Short- versus long-segment posterior spinal fusion with vertebroplasty for osteoporotic vertebral collapse with neurological impairment in thoracolumbar spine: a multicenter study

• Published in: BMC musculoskeletal disorders Vol. 21; no. 1; p. 513
• Main Authors: Ishikawa, Yuya, Watanabe, Kei, Katsumi, Keiichi, Ohashi, Masayuki, Shibuya, Yohei, Izumi, Tomohiro, Hirano, Toru, Endo, Naoto, Kaito, Takashi, Yamashita, Tomoya, Fujiwara, Hiroyasu, Nagamoto, Yukitaka, Matsuoka, Yuji, Suzuki, Hidekazu, Nishimura, Hirosuke, Terai, Hidetomi, Tamai, Koji, Tagami, Atsushi, Yamada, Shuta, Adachi, Shinji, Yoshii, Toshitaka, Ushio, Shuta, Harimaya, Katsumi, Kawaguchi, Kenichi, Yokoyama, Nobuhiko, Oishi, Hidekazu, Doi, Toshiro, Kimura, Atsushi, Inoue, Hirokazu, Inoue, Gen, Miyagi, Masayuki, Saito, Wataru, Nakano, Atsushi, Sakai, Daisuke, Nukaga, Tadashi, Ikegami, Shota, Shimizu, Masayuki, Futatsugi, Toshimasa, Ohtori, Seiji, Furuya, Takeo, Orita, Sumihisa, Imagama, Shiro, Ando, Kei, Kobayashi, Kazuyoshi, Kiyasu, Katsuhito, Murakami, Hideki, Yoshioka, Katsuhito, Seki, Shoji, Hongo, Michio, Kakutani, Kenichiro, Yurube, Takashi, Aoki, Yasuchika, Oshima, Masashi, Takahata, Masahiko, Iwata, Akira, Endo, Hirooki, Abe, Tetsuya, Tsukanishi, Toshinori, Nakanishi, Kazuyoshi, Watanabe, Kota, Hikata, Tomohiro, Suzuki, Satoshi, Isogai, Norihiro, Okada, Eijiro, Funao, Haruki, Ueda, Seiji, Shiono, Yuta, Nojiri, Kenya, Hosogane, Naobumi, Ishii, Ken
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 01-08-2020; BioMed Central; BMC
• Subjects: Aged; Back pain; Bone surgery; Clinical outcomes; Decompression, Surgical; Diabetes; Female; Fractures; Hospitals; Humans; Invasiveness; Kyphosis; Lumbar Vertebrae - diagnostic imaging; Lumbar Vertebrae - injuries; Lumbar Vertebrae - surgery; Male; Musculoskeletal diseases; Neurological complications; Osteoporosis; Osteoporotic Fractures - diagnostic imaging; Osteoporotic Fractures - surgery; Osteoporotic vertebral collapse; Pain; Patients; Posterior spinal fusion; Retrospective Studies; Short-segment; Spinal Fractures - diagnostic imaging; Spinal Fractures - surgery; Spinal fusion; Spinal Fusion - adverse effects; Spine; Surgeons; Surgery; Surgical outcomes; Thoracic Vertebrae - diagnostic imaging; Thoracic Vertebrae - injuries; Thoracic Vertebrae - surgery; Thoracolumbar spine; Treatment Outcome; Vertebrae; Vertebral fracture; Vertebroplasty; Vice presidents (Organizations); Kyphosis; Osteoporotic vertebral collapse; Thoracolumbar spine; Long-segment; Vertebral fracture; Vertebroplasty; Correction loss; Short-segment; Posterior spinal fusion
• ISSN: 1471-2474; 1471-2474
• DOI: 10.1186/s12891-020-03539-0

Vertebroplasty with posterior spinal fusion (VP + PSF) is one of the most widely accepted surgical techniques for treating osteoporotic vertebral collapse (OVC). Nevertheless, the effect of the extent of fusion on surgical outcomes remains to be established. This study aimed to evaluate the surgical outcomes of short- versus long-segment VP + PSF for OVC with neurological impairment in thoracolumbar spine.
We retrospectively collected data from 133 patients (median age, 77 years; 42 men and 91 women) from 27 university hospitals and their affiliated hospitals. We divided patients into two groups: a short-segment fusion group (S group) with 2- or 3-segment fusion (87 patients) and a long-segment fusion group (L group) with 4- through 6-segment fusion (46 patients). Surgical invasion, clinical outcomes, local kyphosis angle (LKA), and complications were evaluated.
No significant differences between the two groups were observed in terms of neurological recovery, pain scale scores, and complications. Surgical time was shorter and blood loss was less in the S group, whereas LKA at the final follow-up and correction loss were superior in the L group.
Although less invasiveness and validity of pain and neurological relief are secured by short-segment VP + PSF, surgeons should be cautious regarding correction loss.