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A comparative study of two reconstruction procedures for osteoporotic vertebral fracture with lumbar spinal stenosis: Posterior lumbar interbody fusion versus posterior and anterior and combined surgery
- Source :
- Journal of Orthopaedic Science. 25:52-57
- Publication Year :
- 2020
- Publisher :
- Elsevier BV, 2020.
-
Abstract
- Background Optimal treatment of lumbar spinal stenosis (LSS) with neurological deficit due to osteoporotic vertebral fractures (OVFs) has been controversial. We assessed the usefulness, safety, and efficacy of posterior lumbar interbody fusion (PLIF) for LSS with neurological deficit due to OVFs and compared this procedure to posterior/anterior combined surgery (PACS). Methods Of 36 consecutive patients with LSS with neurological deficit due to OVFs, 15 underwent PLIF (6 males, 9 females; mean age, 74 years), and 21 underwent PACS (4 males, 17 females; mean age, 70 years). Surgical complications, clinical outcomes (operative time, blood loss, American Spinal Injury Association Impairment Scale [AIS], activities of daily living [ADLs]), and sagittal alignment were investigated. Bony fusion was assessed using plain and functional X-rays and computed tomography scans. Results There were no significant differences in age, sex, or disease or follow-up duration between the groups. Operative time was significantly shorter and intraoperative blood loss significantly less in the PLIF than in the PACS groups. AIS and ADL improved significantly postoperatively in both groups. No significant difference was observed in neurological improvement, correction angle, loss of correction, and surgical complications. No pseudarthrosis occurred, and no patient required additional surgery in the PLIF group. Conclusions PLIF for LSS with neurological deficit due to OVFs achieves posterior rigid fixation with instrumentation, anterior column reconstruction by interbody fusion, and adequate decompression using a single posterior approach. This less invasive procedure is a useful reconstructive surgery option.
- Subjects :
- Male
Reconstructive surgery
medicine.medical_specialty
Decompression
Posterior approach
03 medical and health sciences
Spinal Stenosis
0302 clinical medicine
Blood loss
Lumbar interbody fusion
Surveys and Questionnaires
medicine
Humans
Orthopedics and Sports Medicine
Aged
Fixation (histology)
Aged, 80 and over
030222 orthopedics
Lumbar Vertebrae
business.industry
Lumbar spinal stenosis
Middle Aged
Plastic Surgery Procedures
Decompression, Surgical
medicine.disease
Surgery
Pseudarthrosis
Spinal Fusion
Spinal Fractures
Female
Tomography, X-Ray Computed
business
Osteoporotic Fractures
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 09492658
- Volume :
- 25
- Database :
- OpenAIRE
- Journal :
- Journal of Orthopaedic Science
- Accession number :
- edsair.doi.dedup.....281f538853f59e452cbf980db4c081ab