Manipulative reduction combined with concave-side percutaneous kyphoplasty for the treatment of kyphoscoliosis caused by acute thoracolumbar osteoporotic vertebral compression fractures

Published: 22 November 2019| Version 1 | DOI: 10.17632/xvcgprx776.1
Contributor:
Ding-Jun Hao

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Summary Background: There are no studies on the management of local kyphoscoliosis caused by acute thoracolumbar osteoporotic vertebral compression fractures (ATLOVCF). Objective: To evaluate the safety and efficacy of manipulative reduction combined with concave-side percutaneous kyphoplasty (PKP) in the treatment of local kyphoscoliosis caused by ATLOVCF. Methods: A total of 56 ATLOVCF patients with coronal asymmetric compression fractures treated with manipulative reduction combined with concave-side PKP were retrospectively reviewed. The patients were followed-up regularly and were assessed with clinical and radiological outcomes. The clinical outcomes were assessed with visual analogue scale (VAS) for back pain and oswestry disability index (ODI) for functional status. The radiological outcomes were evaluated with cobb angle of local scoliosis and kyphosis. The cases of leakage of bone cement during surgery and new vertebral fractures during follow-up were also reviewed. Results: Manipulative reduction combined with concave-side PKP was successfully completed in all 56 patients. All patients had significantly improvement on VAS and ODI scores compared with their preoperative values and these improvements remained significant during the follow-up period. Meanwhile, patients had significantly improved cobb angles of local scoliosis and kyphosis postoperatively and the local spine alignments were maintained well during the follow-up period. There were four cases of cement leakage during surgery, but none of them developed clinical symptoms and there was no new vertebral fractures during follow-up. Conclusion: Manipulative reduction combined with concave-side PKP is a safe and effective approach for the treatment of kyphoscoliosis caused by ATLOVCF. It can effectively relieve pain, improve quality of life, and improve spinal local kyphoscoliosis. The translational potential of this article: Manipulative reduction combined with concave-side PKP is a safe and effective technique to treat kyphoscoliosis caused by ATLOVCF through relieving pain, improving quality of life and local deformity, with few complications.

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Spine Surgery

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