Multiple Segment Ponte Osteotomy Combined with Augmented Bone Cement for Oboslete Osteoporotic Vertebrae Compressed Fractures and Kyphosis of Thoracolumbar Vertebrae
CEN Bi-wen，WANG Dayi，SHANG Hui，WU Ya-peng，YANG Qi
Department of Spinal Surgery，Taihe Hospital of Shiyan(Affiliated Hopsital of Hubei Medical University)，Shiyan 442000，Hubei，China
Abstract: Objective To explore the operative technique and effect of multiple segment Ponte osteotomy combined with augmented bone cement in the treatment of old osteoporotic vertebra compressed fracture(OVCF)and kyphosis of thoracolumbar vertebrae．MethodsThe clinical data of 24 cases from our department in recent 5 years who suffered intractable back pain caused by old OVCF and thoracolumbar kyphosis were analyzed retrospectively．All cases were treated by multiple segmental Ponte osteotomy combined with augmented bone cement after preoperative bone mineral density measurement．ResultsThe average numbers of augmented bone cement pedicle screw was 6．5，the average operative duration was 158(ranged 125 ～200)min and the average blood loss was 356(ranged 200 ～560)ml．The cerebrospinal leak was found in 6 cases and curedby treatment．No serious postoperative complications occurred as looseness and broken of screws，injury of nerve，wound infection and bone cement leakage．All cases were followed up from 2 to 2．5 years．The average correcting ratio of screw thoracolumbar kyphosis was 71．85%after the surgery，the corrective rate of last time follow-up was 71．43%，and there was no statistical difference between them(P ＞0．05)．The corrective rates were improved obviously during the follow-up period than pre-operation，and the differences were statistically significant(P ＜ 0．05)．The postoperative Cobb＇s angle of thoracolumbar kyphosis and ODI scores of low back pain were improved obviously than that of pre-operation in all 24 cases，the differences were statistically(P ＜0．05)．The Cobb angle of thoracolumbar kyphosis had no statistical differences in different time points(1-，6-moths，1-and 2 year)after the surgery(P ＞0．05)．The ODI score of the final follow-up(2-year after the surgery)was remarkable lower than that of both instant and 1-month after the surgery(P ＜0．05)，but no statistical differences among the final follow-up and 6-months and 1-year after the surgery(P ＞0．05)．ConclusionsMultiple segment Ponte osteotomy combined with augmented bone cement is suitable for old OVCF and thoracolumbar kyphosis patients with the Cobb＇s angle of thoracolumbar kyphosis ＜50°and the largest compression ratio of single vertebrae ＜0．70．It can achieve good correction，improve the intractable back pain，and is a safe and effective surgical procedure with short operative time，less bleeding and no serious complications．
岑毕文，王达义，尚晖，吴亚鹏，杨棋. Ponte截骨联合骨水泥强化治疗胸腰段陈旧性骨质疏松骨折并后凸畸形[J]. 中国现代手术学杂志, 2017, 21(2): 125-130.
CEN Bi-wen. Multiple Segment Ponte Osteotomy Combined with Augmented Bone Cement for Oboslete Osteoporotic Vertebrae Compressed Fractures and Kyphosis of Thoracolumbar Vertebrae. Chinese Journal of Modern Operative Surgery, 2017, 21(2): 125-130.
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2017, Vol. 21 
