To evaluate the clinical efficacy and safety of short-segment pedicle screw fixation combined with vertebroplasty for the treatment of thoracolumbar osteoporotic compression fractures.

A retrospective case control study was conducted on 63 patients with fresh thoracic or lumbar osteoporotic compression fractures who were surgically treated from January 2010 to December 2013. There were 26 males and 37 females, with age of 63-87 years [(76.3±5.7)years]. According to the surgical method, the patients were assigned to simple vertebroplasty group (Group A), short-segment pedicle screw fixation group (Group B), and short-segment pedicle screw fixation group combined with vertebroplasty group (Group C), with 21 cases in each group. Length of hospital stay, operation time, and blood loss were recorded. The visual analog scale (VAS), anterior vertebral body height, angle of the kyphotic deformity, and complications before operation, immediately after operation, 3 months after operation, and at the last follow up were compared among three groups. Complications of each group were recorded.

The hospital stay, operation time, and blood loss in Group C were significantly higher than those in Group A (P<0.05), but there were no significant differences between Group B and Group C (P>0.05), except for a longer operation time in Group C. The pre-operative VAS showed no significant difference among three groups (P>0.05). However, the mean VAS in Groups A, B and C at the last follow up were 1.0(0.0, 2.0)points, 1.0(0.0, 2.0)points, 0.0(0.0, 1.0)points, respectively. The VAS in Group C was significantly lower than that in Group B or A (P<0.05). The mean anterior vertebral body height and angle of the kyphotic deformity in Group C had no significant difference from that in Group A or B before operation and immediately after operation (P>0.05). At the last follow up, the mean anterior vertebral body height and angle of the kyphotic deformity in Groups A, B and C were (68±14.7)%, (72.3±9.0)%, (81.5±5.6)% and (10.6±3.9)°, (10.7±5.0)°, (7.4±5.0)°, respectively. The loss of anterior vertebral body height and angle of the kyphotic deformity correction in Group C were significantly less than that in Group A or B(P<0.05). Superficial infection was found in Groups B (n=2) and C (n=1), and the infection was cured after antibiotic therapy and dress change. Bone cement leakage was found in Groups A (n=8) and C (n=5), with no nerve compression. Internal fixation failure was seen in Group B (n=3), and the implant was removed directly.

Short-segment pedicle screw fixation combined with vertebroplasty can effectively reduce the loss of anterior vertebral body height and angle of the kyphotic deformity and hence enhance the clinical efficacy.

Spine; Fractures, compression; Osteoporosis; Short-segment pedicle screw fixation