Analysis of conservative and surgical treatment of vertrebral fractures in osteoporosis

Authors

  • A. N. Vitkovskyi Institute of Traumatology and Orthopedics of the National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine

Keywords:

osteoporosis, vertebra, compressive fracture, conservative treatment, pain syndrome, percutaneous vertebroplasty

Abstract

Background.

The analysis of results of conservative and surgical management of 115 patients suffered from vertebral fractures in osteoporosis, is presented in the research, that has been provided in Vertebral Surgery Department of Institute of Orthopedics and Traumatology of the NAMS of Ukraine (Kyiv) in 2014–2016.

Research object.

The aim of the research was to make an analysis of conservative and surgical treatment of vertebral fractures considering features of clinical signs of spine osteoporosis.

Methods and materials.

The research is based on the analysis of the results of examination and conservative and surgical managements of 115 cases with compression vertebral fractures of thoracic and lumbar spine in hospital patients with vertebral osteoporosis treated at the Vertebral Surgery Department. There were 50 to 80 years old patients, the majority of them were women – 93 (80.86 %). The management consisted of taking anamnesis, examination, clinical and laboratory tests, X-ray densitometry, spondylography in functional position in two projections, MRI and CT. All of 115 patients were treated conservatively and surgically after the examination.

Results and discussion.

There was made an analysis of conservative and surgical treatment of patients suffered from compressive vertebral fractures in case of spine osteoporosis. It should be noticed that conservative methods of management demand longer period of in-patient treatment, durable stage of rehabilitation followed by exacerbation of chronic somatic diseases. Patients disappointed by the results of conservative treatment were treated surgically: percutaneous vertebroplasty of fractured vertebras. Percutaneous vertebroplasty is an alternative method of management to conservative treatment of fractured vertebras in osteoporosis. As a result, surgical treatment (percutaneous vertebroplasty in osteoporosis) has more benefits and allows to improve the quality of life for the very short term, in the first day after fracture. Summary. The majority of patients with spine osteoporosis, complicated by compressive vertebral fractures, constituteв 93 women (80.9%), and 50 patents, aged over 70 (43.5 %). Secondary osteoporosis was determined only in 15 patients (13.0 %). The pain syndrome with moderate intensity was typical for vertebral fractures against the background of osteoporosis. 29 patients (25.2 %) had neurological disorders manifested by sensitive disturbances. Disturbances of reflexes were noticed in 22 (19.1 %) cases. Hypotrophy and diminished muscle power of lower extremities were diagnosed in 13 (11.25 %) patients. Pelvic organs lesions were noticed in 11 (19.6 %) cases. Positive result of conservative treatment occurred in 58 (50.4 %) cases, and acceptable – in 34 (29.6 %) patients. Insufficient result was noticed in 23 (20 %) cases, pain syndrome and limitation of movements persisted. 115 patients underwent percutaneous vertebroplasty of fractured bones after conservative treatment with the aim to prevent further compression and development of spine deformation. The percutaneous vertebroplasty by its results is the alternative way of treatment to conservative management of compressive vertebral fractures in patients with osteoporosis. Improvement of condition was noticed in 97 (84.4 %) cases – positive result. Acceptable effects were in 12 (10.4 %) cases. 6 patients had insufficient result, that appeared with mild residual vertebrogenic pain and limitation of movements in affected spine segment.

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References

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Published

2017-12-01

How to Cite

1.
Vitkovskyi AN. Analysis of conservative and surgical treatment of vertrebral fractures in osteoporosis. PMJUA [Internet]. 2017Dec.1 [cited 2021Jan.20];2(4):77-82. Available from: https://painmedicine.org.ua/index.php/pnmdcn/article/view/75

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Original article