Surgical Treatment for Delayed Paraparesis Following Vertebral Compression Fracture in Osteoporotic Patients.

概要

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We evaluated the operative results in 8 cases with delayed paraparesis resulting from osteoporotic vertebral fractures. Two cases were treated by anterior decompression and fusion, six were treated by posterior decompression and fusion with instrumentation. All cases were evaluated using the JOA score, walking ability and radiologic findings regarding postoperative progression of kyphosis, bone union and instrument failure. All cases showed neurologic recovery, but the progression of kyphosis after surgery could not be prevented. The pathogenesis of neurologic deficits was via compression of neural tissue due to retropulsion of the posterior part of the collapsed vertebral body into the spinal canal and the increasingly-unstable kyphosis. In cases with neurologic deficits due to increasingly-unstable kyphosis and in patients who are in a worse clinical condition, we should also consider the posterior Surgical approach.
西日本整形・災害外科学会の論文