Objective: To evaluate the feasibility, clinical efficacy and imaging results of preoperative traction (PT) followed by percutaneous kyphoplasty (PKP) combined with percutaneous cement discoplasty (PCD) for treating severe thoracolumbar osteoporotic vertebral compression fractures (OVCFs).
Methods: A total of 13 patients with severe thoracolumbar OVCFs treated by PT followed by PKP combined with PCD were enrolled. General information, PT time, operation time, postoperative hospital stay, perioperative complications, visual analog scale (VAS) score, Oswestry disability index (ODI) score, local kyphosis angle, intervertebral angle (IVA), anterior vertebral height (AVH) and posterior vertebral height (PVH) were recorded.
Results: The average VAS score at admission was 7.4± 3.5, decreased to 4.3± 1.7 after PT and 2.3± 0.7 three days after operation, and 1.5± 0.9 at last follow-up. The average ODI score was 73.7± 21.4 before operation, decreased to 26.6± 9.3 three days after operation and 13.7± 7.1 at last follow-up. Compared to VAS and ODI scores at admission, these at the third day after operation and last follow-up were significantly different. At admission, the IVA was 3.4°± 6.8°, the disc height was 5.7± 1.2mm, the AVH was 10.7± 3.2mm, and the PVH was 25.7± 4.2 mm, which, after PT, changed to 8.1°± 7.3°, 8.6± 2.6mm, 18.5± 2.8mm, and 26.2± 7.1mm, respectively, and the differences were significant. The average kyphotic angle was 43.4°± 17.8° at admission, and decreased to 26.3°± 6.7° after PT, 17.5°± 8.4° three days after operation and 19.1°± 10.3° at last follow-up, and the differences were significant.
Conclusion: PT followed by PKP combined with PCD for the treatment of severe thoracolumbar OVCFs was an effective and simple procedure with satisfactory short-term clinical outcomes by relieving pain and improving kyphosis.
Keywords: osteoporosis, spinal fracture, kyphosis, traction, percutaneous kyphoplasty, percutaneous cement discoplasty