The application of biopsy and kyphoplasty in the diagnosis and treatment of osteoporotic thoracolumbar vertebral compression fracture nonunion / 中华外科杂志

ABSTRACT

<p><b>OBJECTIVES</b>To investigate the clinical efficacy and safety of biopsy and Kyphoplasty in the diagnosis and treatment of osteoporotic thoracolumbar vertebral fracture nonunion, and to explore the clinical characteristics of the disease.</p><p><b>METHODS</b>From July 2005 to May 2010, the clinical data of 8 patients with nonunion of osteoporotic thoracolumbar vertebral fractures were studied. There were 3 males and 5 females, with the mean age of 73.5 years (range, 65 - 86 years). The fracture vertebrae were 3 cases in T(12), 4 in L(1), and 1 in L(2). All cases received radiography, CT and MRI examination. All patients were treated by using Kyphoplasty. Five patients were performed bone biopsy successfully, 3 patients were failed. The curative effect was evaluated by visual analogue scale (VAS), anterior vertebral height restoration at preoperative, postoperative and followed-up time.</p><p><b>RESULTS</b>All patients tolerated the procedure well with immediate relief of back pain after Kyphoplasty. No severe complications were found in all patients. Three cases had the pathologic appearance of sequestrum, 2 cases were sparse cancellous bone, 3 cases were abortive to biopsy. All the patients were followed up of 22.6 months (range, 3 - 37 months), the VAS was 9.5 before operation, 2.1 at the third day postoperatively, there were significant difference between the two phase (P < 0.05), and 2.3 at last follow-up, there were no difference between postoperation and follow-up phase (P > 0.05). And the height of compressed body recovered markedly. The vertebral height had a recovery rate of 67.2% postoperatively, 64.1% and at last follow-up, there were no difference between the two phase (P > 0.05).</p><p><b>CONCLUSIONS</b>Kyphoplasty is an effective and safe method in the treatment of osteoporotic throacolumbar vertebral fracture nonunion. Bone biopsy can play a further role of differential diagnosis.</p>