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Findings support inclusion of osteoporosis care for patients with osteoporotic vertebral collapse
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Researchers of this retrospective study conducted at a single institution discovered low lumbar osteoporotic vertebral collapse can generate neurological symptoms of foraminal stenosis and/or canal stenosis in elderly patients.
Researchers included 30 patients who underwent surgical treatment for low lumbar osteoporotic vertebral collapse (OVC) affecting levels below L3. The mean age of patients was 79.3 ± 4.7 years. At a mean 2.4-years follow-up, clinical symptoms, sagittal spinopelvic alignment, neurological status and morphological features of affected vertebra were evaluated for each patient.
The main symptom in patients with OVC was radicular leg pain. On CT and MRI, researchers found 60% (18 patients) developed foraminal stenosis and 80% (24 patients) developed canal stenosis. The morphological features of OVC in patients with low lumbar vertebra are flat-type and concave or H-shaped type, researchers noted.
Decompression with short fusion using a posterior approach was performed in the patients. However, augmentations of vertebroplasty, posterolateral fusion and posterior lumbar interbody fusion were performed depending on the presence or absence of local kyphosis of the lumbar spine, cleft formation, and/or intervertebral instability were found in a patient, according to the researchers.
Researchers found the mean JOA score improved significantly from 13.8 ± 5.5 preoperatively to 22.4 ± 5.9 at follow-up. They discovered the mean improvement rate was 61.4% ± 24.8%. VAS scores showed a significant improvement. However, 26.7% of patients developed postoperative complications.
Researchers concluded most patients presenting with low lumbar OVC are elderly and have poor bone quality, so treatments for both OVC and osteoporosis should be provided. – by Robert Linnehan.
Disclosure: The researchers report no relevant financial disclosures.
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