Short-segment posterior instrumentation combined with calcium sulfate cementvertebroplasty for thoracolumbar compression fractures: Radiographic outcomesincluding nonunion and other complications

摘要

Objective. - To evaluate the radiographic outcomes of short-segment posterior instrumentation plusvertebroplasty using injectable calcium sulfate cement (CSC) for thoracolumbar compression fractures.Materials and methods. - Twenty-eight patients with a single-level thoracolumbar compression fracture,who underwent short-segment pedicle screw fixation and CSC vertebroplasty, were included in the study.The anterior vertebral body height ratio, local kyphosis angle, and the height of the intervertebral diskadjacent to the fractured vertebra were used to evaluate the radiographic results. Complications includingbone nonunion, instrument failure, cement leakage, and disc vacuum formation were also assessed.Results. - The patients were followed up for an average of 24.20 ± 5.40 months. The relative preoperativeanterior body height was 55.71 ±15.29%, which improved to 94.93 ±5.39% immediately after surgery(P< 0.001), and at final follow-up showed a 6.50 ±3.89% loss of height correction (P< 0.001). The meanpreoperative local kyphosis angle was 22.23 ±5.65°, which corrected to 2.67 ±4.43° immediately aftersurgery (P<0.001), but reverted to 6.71 ±4.95° at final follow-up, showing a 4.04±1.91° loss of cor-rection (P< 0.001). The mean height of the intervertebral disk proximal to the fractured vertebra was9.87 ±0.91 mm before surgery, 12.53 ±0.98 mm after operation (P< 0.001), and the loss of correction atfinal follow-up was 2.35 ±1.15 mm with a significant difference compared to immediate postoperativevalues (P< 0.001). Bone nonunion occurred in 7 patients, 2 patients had hardware failure, 9 patients hadcement leakage, and 10 patients had disc vacuum phenomenon adjacent to the fractured vertebra.Conclusions. - The patients who underwent this procedure had a loss of correction of vertebral heightand local kyphosis. Complications such as bone nonunion, instrument failure, cement leakage, and discvacuum may occur. Rapid CSC resorption accounts for these radiographic outcomes and complications.Level of evidence. - Level IV, retrospective study.