Open kyphoplasty and decompressive laminectomy for osteoporotic vertebral burst fractures in the elderly patients

Abstract

Objective To evaluate clinical results of open kyphoplasty combined with decompressive laminectomy for osteoporotic vertebral burst fractures (OVBF) in the elderly patients. Methods Between September 2005 and June 2010,21 OVBF patients,8 men and 13 women,were treated in Beijing Hospital.They were aged from 72 to 89 years (average,80.4 years).Open kyphoplasty and decompressive laminectomy was performed for all the patients.Blood loss,surgery time and complications were recorded.Pain was measured preoperatively,postoperatively and at the last follow-up by visual analogue scale (VAS).Spinal functions were also measured preoperatively,postoperatively and at the last follow-up by the Oswestry Disability Index (ODI) score.Correction of the kyphosis was evaluated by comparing the Cobb's angles before and after operation. Results A mean follow-up of 10.5 months (from 3 to 27 months) revealed recovery of the preoperative neural dysfunction.The mean blood loss and surgery time were 238 mL 85 minutes respectively.Cement leakage was found in 5 cases,cerebrospinal fluid leakage in one case,and incision liquefaction in 2 cases.No significant spinal or neural complications were observed.On Day one before operation,Day 7 after operation and at the final follow-up,the mean VAS scores were respectively 7.2 ± 1.2,2.3 ±0.5 and 2.8±0.3; the mean ODI scores were respectively 70.5±5.8,30.2 ±3.0 and 32.7±1.5;the mean Cobb's angles were respectively 22.5°±3.5°,16.5°±2.3° and 15.8° ± 1.1°.There were significant differences between preoperation and postoperation,but no significant differences between postoperative time points. Conclusion Open kyphoplasty and decompressive laminectomy may be a relatively safe and effective treatment for elderly patients with painful OVBF,especially for those who are contraindicated for traditional percutaneous kyphoplasty. Key words: Spine fractures; Osteoporosis; Vertebroplasty; Vertebral decompression