P52. Manipulative reduction combined with concave side percutaneous kyphoplasty for treatment of kyphoscoliosis deformity caused by thoracolumbar osteoporotic vertebral compression fracture

Abstract

BACKGROUND CONTEXT Local kyphoscoliosis deformity caused by coronal asymmetric vertebral compression fracture due to osteoporosis is very rare. As far as we know, there are no related reports. PURPOSE To evaluate the efficacy and safety of manipulative reduction combined with concave side percutaneous kyhphoplasty (PKP) in the treatment of kyphoscoliosis deformity caused by thoracolumbar osteoporotic vertebral compression fractures (OVCF). STUDY DESIGN/SETTING A retrospective study. PATIENT SAMPLE Twenty-eight thoracolumbar OVCF patients with coronal asymmetric compression fractures from January 2016 to January 2017. OUTCOME MEASURES The visual analog score (VAS), Oswestry Disability Index (ODI), Cobb angle of local kyphosis and scoliosis of local spine. METHODS A retrospective analysis of 28 thoracolumbar OVCF patients with coronal asymmetric compression fractures admitted to our hospital from January 2017 to January 2018 was conducted, including 10 male and 18 female patients, with an average age of 68.3±5.5 years. Preoperative CT or X-ray confirmed lateral and anterior compression fracture of vertebral body, and MRI suggested fresh vertebral fracture. All patients underwent extension and reverse lateral flexion position to reduce preoperatively, and concave side PKP under local anesthesia. The VAS, ODI, Cobb angle of local kyphosis and scoliosis were recorded before the surgery, at 1 day after operation and at the last follow-up. RESULTS Surgery of all patients went successfully, with an average follow-up of 16.1 ± 3.4 months. Before and 1 day after surgery, and at the last follow-up, the patient's VAS scores were 8.3±0.6, 2.5±0.6, and 2.2±0.4, respectively, and the ODI scores were 48.5±8.7, 20.2±5.6, and 18.6±5.5, respectively. The VAS and ODI score were significantly improved at 1 day after surgery and at the last follow-up (P 0.05). Before and 1 day after surgery, and at the last follow-up, the Cobb angles of local kyphosis of the injured vertebrae were 23.4±2.3°, 10.7±.1.8°, and 11±2.5°, and the Cobb angles of the scoliosis were 10.5±1.7° and 3.2±2.2°, and 4.1±2.4°, respectively. The kyphosis and scoliosis Cobb angle were significantly improved at 1 day after the surgery and at the last follow-up (P 0.05). During the operation, one case occurred cement leakage in front of vertebral body, and 2 cases had concave side cement leakage, all of which did not lead to any clinical symptom. No new vertebral fractures occurred during the follow-up period. CONCLUSIONS Manipulative reduction combined with concave side PKP is a safe and effective method for the treatment of kyphoscoliosis deformity caused by thoracolumbar OVCF. It can effectively relieve pain, improve the quality of life and improve local kyphoscoliosis deformity of local spine. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.