Anterior Vertebral Reconstruction Surgery using Polymethylmethacrylate and Posterior Spinal Short Fusion through the Posterior Approach for Osteoporotic Vertebral Pseudoarthrosis

ABSTRACT

Background: Cases of osteoporotic vertebral pseudoarthrosis (PA) with severe back pain and neurologic deficit are being increasingly reported. The lack of anterior structure and osteoporosis are the most serious problems in surgery for vertebral PA. We propose here a surgical procedure with posterior spinal short fusion and anterior support using polymethylmethacrylate through the posterior approach. Materials/Methods: PA involved the vertebrae of the thoracolumbar junction in five patients. The mean postsurgical follow-up period was 35.8 months. Results: The mean kyphotic angle of affected vertebrae improved from 21.6±9.4˚ before to 9.8±7.3˚ after surgery (P<0.05). Severe back pain resolved in all patients postoperatively. The correction loss of kyphosis was only 2˚ at final follow-up. We encountered no major complications including cement leakage, spinal cord damage, or deep-tissue infection. Conclusions: Since this procedure provides spinal stability and allows safe neural decompression, it may be a useful surgical procedure for the treatment of osteoporotic PA. However, to prevent sequential vertebral fractures at the adjacent level, additional countermeasures are necessary.

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