Anterior column opening structural bone grafting with posterior column compression technique for the treatment of obsolete vertebral compression fractures with severe spinal kyphosis

Abstract

OBJECTIVES:

We aimed to evaluate the efficacy and safety of anterior column opening structural bone grafting with posterior column compression technique for the treatment of obsolete vertebral compression fractures with severe spinal kyphosis.

METHODS:

Fourteen patients with senile obsolete vertebral compression fractures and severe spinal kyphosis were admitted to our hospital. During the treatment processing, an “eggshell” osteotomy, anterior column opening structural bone grafting with posterior column compression, and pedicle screw internal fixation were performed in all patients. The Cobb angle, Visual Analogue Scale (VAS) score, Oswestry Disability Index (ODI) pre-operatively, post-operatively, and at the last follow-up were analyzed. Furthermore, the intra-operative blood loss and the operative time were also analyzed.

RESULTS:

The average osseous fusion time was 3.6 months (range from 3 to 5 months). The average operative time was 236 $\pm$ 20.1 min (range from 198 to 261 min). The average intra-operative blood loss was 1350.5 $\pm$ 70.2 ml (range from 809 to 2216 ml). The Cobb angle of localized kyphosis was 63.4 $\pm$ 12.4 ${}^{\circ }$ pre-operatively, while 10.0 $\pm$ 2.1 ${}^{\circ }$ post-operatively, and 12 $\pm$ 3.4 ${}^{\circ }$ at the last follow-up evaluation, respectively. The average VAS score was decreased significantly from 8.7 $\pm$ 3.2 pre-operatively to 1.9 $\pm$ 0.4 post-operatively. The average ODI score was decreased from 78.3 $\pm$ 2.4% pre-operatively to 19.3 $\pm$ 5.3% post-operatively.

CONCLUSIONS:

Anterior column opening structural bone grafting with posterior column compression technique is effective, can effectively restore the sagittal balance of the spine, ease pain, and improve the quality of life of the patients with obsolete vertebral compression fractures and spinal kyphosis.