The surgical outcomes of spinal fusion for osteoporotic vertebral fractures in the lower lumbar spine with a neurological deficit

Norihiro Isogai, Naobumi Hosogane, Haruki Funao, Kenya Nojiri, Satoshi Suzuki, Eijiro Okada, Seiji Ueda, Tomohiro Hikata, Yuta Shiono, Kota Watanabe, Kei Watanabe, Takashi Kaito, Tomoya Yamashita, Hiroyasu Fujiwara, Yukitaka Nagamoto, Hidetomi Terai, Koji Tamai, Yuji Matsuoka, Hidekazu Suzuki, Hirosuke NishimuraAtsushi Tagami, Shuta Yamada, Shinji Adachi, Seiji Ohtori, Sumihisa Orita, Takeo Furuya, Toshitaka Yoshii, Shuta Ushio, Gen Inoue, Masayuki Miyagi, Wataru Saito, Shiro Imagama, Kei Ando, Daisuke Sakai, Tadashi Nukaga, Katsuhito Kiyasu, Atsushi Kimura, Hirokazu Inoue, Atsushi Nakano, Katsumi Harimaya, Kenichi Kawaguchi, Nobuhiko Yokoyama, Hidekazu Oishi, Toshiro Doi, Shota Ikegami, Masayuki Shimizu, Toshimasa Futatsugi, Kenichiro Kakutani, Takashi Yurube, Masashi Oshima, Hiroshi Uei, Yasuchika Aoki, Masahiko Takahata, Akira Iwata, Shoji Seki, Hideki Murakami, Katsuhito Yoshioka, Hirooki Endo, Michio Hongo, Kazuyoshi Nakanishi, Tetsuya Abe, Toshinori Tsukanishi, Ken Ishii

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: Osteoporotic vertebral fracture (OVF) is the most common osteoporotic fracture, and some patients require surgical intervention to improve their impaired activities of daily living with neurological deficits. However, many previous reports have focused on OVF around the thoracolumbar junction, and the surgical outcomes of lumbar OVF have not been thoroughly discussed. We aimed to investigate the surgical outcomes for lumbar OVF with a neurological deficit. Methods: Patients who underwent fusion surgery for thoracolumbar OVF with a neurological deficit were enrolled at 28 institutions. Clinical information, comorbidities, perioperative complications, Japanese Orthopaedic Association scores, visual analog scale scores, and radiographic parameters were compared between patients with lower lumbar fracture (L3-5) and those with thoracolumbar junction fracture (T10-L2). Each patient with lower lumbar fracture (L group) was matched with to patients with thoracolumbar junction fracture (T group). Results: A total 403 patients (89 males and 314 females, mean age: 73.8 ± 7.8 years, mean follow-up: 3.9 ± 1.7 years) were included in this study. Lower lumbar OVF was frequently found in patients with lower bone mineral density. After matching, mechanical failure was more frequent in the L group (L group: 64%, T group: 39%; p < 0.001). There was no difference between groups in the clinical and radiographical outcomes, although the rates of complication and revision surgery were still high in both groups. Conclusions: The surgical intervention for OVF is effective in patients with myelopathy or radiculopathy regardless of the surgical level, although further study is required to improve clinical and radiographical outcomes.

Original languageEnglish
Pages (from-to)199-207
Number of pages9
JournalSpine Surgery and Related Research
Volume4
Issue number3
DOIs
Publication statusPublished - Jan 2020

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology
  • Orthopedics and Sports Medicine

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