Repair strategies for nonunion in old osteoporotic vertebral compression fractures: a case analysis

doi:10.12307/2025.132

Abstract

Abstract: BACKGROUND: Patients with osteoporotic compression fractures of the lumbar spine have varying degrees of changes in the sagittal parameters of the spine and pelvis, resulting in disequilibrium and rebalancing of the sagittal plane of the whole spine/lumbar spine. If the primary osteoporotic vertebral compression fracture is not treated promptly, it develops into an old osteoporotic vertebral compression fracture with nonunion over time.
OBJECTIVE: To observe the effect of percutaneous vertebroplasty in nine patients with old osteoporotic lumbar compression fracture with nonunion.
METHODS: A retrospective analysis was conducted on the clinical data of nine elderly patients with old osteoporotic lumbar compression fractures with nonunion treated in the Orthopedics Department of Shanghai Public Health Clinical Center from September 2018 to August 2022. All patients underwent revision treatment with percutaneous vertebroplasty and received regular anti-osteoporosis treatment and rehabilitation training. The lumbar spine X-ray plain film and three-dimensional CT test results were reviewed before discharge and during follow-up to evaluate the diffusion of bone cement. Visual analog scale score, lumbar Oswestry disability index score, and Roussouly classification were recorded before, after surgery and during follow-up.
RESULTS AND CONCLUSION: (1) During postoperative follow-up, none of the 9 cases in this group experienced serious surgical complications such as nerve injury, infection, bone cement leakage, pulmonary embolism, and allergic shock, and no adverse reactions related to bone cement occurred. One patient died of respiratory failure due to COVID-19 infection 2 years after operation. (2) The visual analog scale score and Oswestry disability index score of postoperative pain in patients with recurrent vertebral fractures after percutaneous vertebroplasty were significantly lower than those before revision surgery. After the last follow-up percutaneous vertebroplasty revision surgery, the Roussouly classification of patients significantly improved. There was no statistically significant difference between the changes in vertebral body height during the last follow-up measurement and preoperative comparison. (3) These findings indicate that for patients with old osteoporotic lumbar compression fractures with nonunion, moderate injection of bone cement and effective dispersion of bone cement have a significant relieving effect on postoperative pain. Regular anti-osteoporosis and effective postoperative rehabilitation training can help patients improve their postoperative lumbar spine function.

Key words: osteoporosis, percutaneous vertebroplasty bone cement injection technology, vertebroplasty, refractures of surgical vertebrae, Roussouly lumbar functional classification, stress concentration zone

CLC Number:

Zhao Xingcheng, Wang Jun, Lu Ming. Repair strategies for nonunion in old osteoporotic vertebral compression fractures: a case analysis[J]. Chinese Journal of Tissue Engineering Research, 2025, 29(3): 538-546.

Figures/Tables 11

References

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