2022, Vol. 26 ›› Issue (27): 4279-4282

Bone cement injection for incomplete posterior wall osteoporotic fractures without neurological symptoms: a 4-year follow-up

Wang Lingjun, Gu Yong, Feng Yu, Chen Liang, Lin Ziyu   

Abstract: BACKGROUND: At present, there is considerable controversy in the treatment of osteoporotic patients with posterior wall rupture. Some scholars believe that it is a contraindication to bone cement augmentation and is suitable for open reduction and internal fixation; however, some scholars believed that osteoporosis can easily lead to failure of internal fixation, and minimally invasive bone cement augmentation can be performed under appropriate conditions.
OBJECTIVE: To investigate the clinical effect of bone cement injection for incomplete posterior wall osteoporotic fractures without neurological symptoms.
METHODS: Data of 31 patients (12 males and 19 females; age range: 57 to 82 years old) with osteoporotic vertebral compression fracture with imcomplete posterior wall, which admitted to the First Affiliated Hospital of Soochow University from January 2011 to June 2013, were retrospectively analyzed. All patients were treated with balloon kyphoplasty, and the leakage of bone cement was evaluated. X-ray examination was carried out preoperatively, at 1 day, 3 months postoperatively and the last follow-up to measure the height of vertebral body and Cobb angle. The curative effect was evaluated by visual analogue scale score and Oswestry dysfunction index.
RESULTS AND CONCLUSION: (1) Three out of 31 patients affected sidewall bone cement leakage and the patients had no remarkable neurological symptoms. (2) All 31 patients were followed up for a mean time of (47.2±24.3) months. At 1 day and 3 months and the last follow-up after treatment, the mean height of the vertebral body was higher than that before treatment (P < 0.05) and Cobb angle was smaller than that before treatment (P < 0.05). Visual analogue scale score and Oswestry dysfunction index were lower at 1 day and 3 months and the last follow-up after treatment than those before treatment (P < 0.05). (3) It is concluded that kyphoplasty is safe and effective in the treatment of osteoporotic vertebral compression fracture with incomplete posterior wall. It can dramatically relieve pain, increase the height of the vertebral body, and reduce kyphosis.
Key words: osteoporosis, spine fracture, bone cement, kyphoplasty, clinical efficacy, vertebral body strengthening, posterior wall rupture