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Multicenter Study
. 2020 Aug 1;21(1):513.
doi: 10.1186/s12891-020-03539-0.

Short- versus long-segment posterior spinal fusion with vertebroplasty for osteoporotic vertebral collapse with neurological impairment in thoracolumbar spine: a multicenter study

Yuya Ishikawa  1 , Kei Watanabe  2 , Keiichi Katsumi  1 , Masayuki Ohashi  1 , Yohei Shibuya  1 , Tomohiro Izumi  1 , Toru Hirano  1 , Naoto Endo  1 , Takashi Kaito  3 , Tomoya Yamashita  3 , Hiroyasu Fujiwara  3 , Yukitaka Nagamoto  3 , Yuji Matsuoka  4 , Hidekazu Suzuki  4 , Hirosuke Nishimura  4 , Hidetomi Terai  5 , Koji Tamai  5 , Atsushi Tagami  6 , Shuta Yamada  6 , Shinji Adachi  6 , Toshitaka Yoshii  7 , Shuta Ushio  7 , Katsumi Harimaya  8 , Kenichi Kawaguchi  8 , Nobuhiko Yokoyama  8 , Hidekazu Oishi  8 , Toshiro Doi  8 , Atsushi Kimura  9 , Hirokazu Inoue  9 , Gen Inoue  10 , Masayuki Miyagi  10 , Wataru Saito  10 , Atsushi Nakano  11 , Daisuke Sakai  12 , Tadashi Nukaga  12 , Shota Ikegami  13 , Masayuki Shimizu  13 , Toshimasa Futatsugi  13 , Seiji Ohtori  14 , Takeo Furuya  14 , Sumihisa Orita  14 , Shiro Imagama  15 , Kei Ando  15 , Kazuyoshi Kobayashi  15 , Katsuhito Kiyasu  16 , Hideki Murakami  17   18 , Katsuhito Yoshioka  18 , Shoji Seki  19 , Michio Hongo  20 , Kenichiro Kakutani  21 , Takashi Yurube  21 , Yasuchika Aoki  22 , Masashi Oshima  23 , Masahiko Takahata  24 , Akira Iwata  24 , Hirooki Endo  25 , Tetsuya Abe  26 , Toshinori Tsukanishi  26 , Kazuyoshi Nakanishi  27 , Kota Watanabe  28 , Tomohiro Hikata  28 , Satoshi Suzuki  28 , Norihiro Isogai  28   29 , Eijiro Okada  28 , Haruki Funao  28   29 , Seiji Ueda  28 , Yuta Shiono  28 , Kenya Nojiri  28 , Naobumi Hosogane  28   30   29 , Ken Ishii  28   29
Affiliations
Multicenter Study

Short- versus long-segment posterior spinal fusion with vertebroplasty for osteoporotic vertebral collapse with neurological impairment in thoracolumbar spine: a multicenter study

Yuya Ishikawa et al. BMC Musculoskelet Disord. .

Abstract

Background: Vertebroplasty with posterior spinal fusion (VP + PSF) is one of the most widely accepted surgical techniques for treating osteoporotic vertebral collapse (OVC). Nevertheless, the effect of the extent of fusion on surgical outcomes remains to be established. This study aimed to evaluate the surgical outcomes of short- versus long-segment VP + PSF for OVC with neurological impairment in thoracolumbar spine.

Methods: We retrospectively collected data from 133 patients (median age, 77 years; 42 men and 91 women) from 27 university hospitals and their affiliated hospitals. We divided patients into two groups: a short-segment fusion group (S group) with 2- or 3-segment fusion (87 patients) and a long-segment fusion group (L group) with 4- through 6-segment fusion (46 patients). Surgical invasion, clinical outcomes, local kyphosis angle (LKA), and complications were evaluated.

Results: No significant differences between the two groups were observed in terms of neurological recovery, pain scale scores, and complications. Surgical time was shorter and blood loss was less in the S group, whereas LKA at the final follow-up and correction loss were superior in the L group.

Conclusion: Although less invasiveness and validity of pain and neurological relief are secured by short-segment VP + PSF, surgeons should be cautious regarding correction loss.

Keywords: Correction loss; Kyphosis; Long-segment; Osteoporotic vertebral collapse; Posterior spinal fusion; Short-segment; Thoracolumbar spine; Vertebral fracture; Vertebroplasty.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Using lateral radiographs, local kyphosis angle (LKA) was measured between the upper endplate of the vertebra one above the affected level and the lower endplate of the vertebra one below the affected level using the Cobb method
Fig. 2
Fig. 2
Surgical time and blood loss in the S and L groups. Each box indicates interquartile range and line in the box indicates median value. Bar is minimum to maximum; ** p < 0.01, *** p < 0.001
Fig. 3
Fig. 3
Changes in local kyphosis angle preoperatively, postoperatively, and at final follow-up in the S and L groups; ns not significant, * p < 0.05
See this image and copyright information in PMC

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