Turkish Neurosurgery
Percutaneous Vertebroplasty for the Treatment of Osteoporotic Thoracolumbar Fractures with Posterior Body Involved in Elderly Patients
Kerem Mazhar Ozsoy1, Kadir Oktay2, Yurdal Gezercan3, Nuri Eralp Cetinalp1, Ali Ihsan Okten3, Tahsin Erman1
1Cukurova University, Faculty of Medicine, Neurosurgery Department, Adana,
2Mehmet Akif İnan Training and Research Hospital, Neurosurgery Department, Sanliurfa,
3Adana Numune Training and Research Hospital, Neurosurgery Department, Adana,
DOI: 10.5137/1019-5149.JTN.22658-18.2

Aim:The management of thoracolumbar burst fractures without neurological symptoms remains controversial. Certain authors have suggested that vertebroplasty and kyphoplasty are contraindicated in patients with burst fractures. However, we performed vertebroplasty to treat intractable pain, reduce surgical risk and achieve early mobilization.Material and Methods:Twelve patients older than 65 years of age with thoracolumbar fractures without neurological deficits underwent vertebroplasty. In all fractures, the anterior and middle columns of the vertebrae were affected, and the canal was mildly compressed. To assess subjects’ clinical symptoms and the effects of the procedure, the patients’ mobility and pain were assessed prior to the procedure and at 1 day and 3 months following the procedure. Results:Improvements in pain and mobility were observed immediately following vertebroplasty in all patients. These results persisted for 3 months. There were significant improvements at 1 day and 3 months after vertebroplasty, specifically pain was reduced by at least 4 levels at 3 months. No comorbidities were noted. However, tomography revealed evidence of polymethylmethacrylate leakage through the endplate fracture site into the disc space or the paravertebral space in 4 vertebrae and minimal intracanal leakage through the fracture tract in 1 patient.Conclusion:Although vertebroplasty is assumed to be contraindicated in osteoporotic thoracolumbar fractures with posterior body involved, we successfully used this procedure to safely treat such fractures without introducing neurological deficits. Percutaneous vertebroplasty may be an alternative method of treating thoracolumbar burst fractures that avoids the complications of major surgical procedures and achieves early mobilization and pain relief.

Corresponding author : Kadir Oktay