Posterior unilateral vertebral column resection for old thoracolumbar compressive fracture accompa-nied with kyphotic deformity

Abstract

Objective To describe a successful method by which vertebral column resection is performed through a unilateral posterior approach for old thoracolumbar compressive fracture accompanied with kyphotic deformity. Methods From February 2009 to January 2013, 49 patients with old thoracolumbar compressive fracture accompanied with kyphotic deformity were treated at our department. Twenty-three of them were treated by posterior unilateral vertebral column resection (PUVCR), and 26 by posterior vertebral column resection (PVCR). The 2 groups were compatible in general clinical data (P>0.05). Their clinical records were reviewed and compared in terms of operation time, intraoperative blood loss, postoperative drainage, correction of kyphotic deformity, neural functional improvement by Oswestry disability index (ODI), and pain by visual analogue scale (VAS). Results The operation time, intraoperative blood loss and postoperative drainage in the PUVCR group were significantly less than in the PVCR group (P 0.05). No significant differences were observed between the 2 groups either in terms of improved ODI or decreased VAS at one-year follow-up (P>0.05). Conclusions In treatment of old thoracolumbar compressive fracture accompa-nied with kyphotic deformity, PUVCR can achieve satisfactory correction of sagittal deformity, neural func-tional improvement and pain relief as well as conventional osteotomy, but it has advantages of shorter operation time, reduced blood loss and decreased incidence of nerve root impingement. Key words: Thoracic vertebrae; Lumber vertebrae; Fractures, bone; Osteotomy