2016, Vol.23, No.3

Journal of Korean Society of Spine Surgery 2023 KCI Impact Factor : 0.03

pISSN : 2093-4378 / eISSN : 2093-4386
https://journal.kci.go.kr/krspine

Study Design: Retrospective study. Objectives: To compare the treatment outcomes of conservative treatment, early vertebroplasty (EVP), and delayed VP (DVP) of patients with osteoporotic compression fractures. Summary of Literature Review: VP is regarded as an effective treatment for osteoporotic compression fractures. Few studies have compared the outcomes of each of the following treatments: conservative treatment, EVP, and DVP. Materials and Methods: A total of 202 patients who presented with thoracolumbar osteoporotic vertebral compression fractures between January 2008 and December 2013 were divided into three groups: group 1 (conservative treatment), group 2 (VP within three weeks), and group 3 (VP after three weeks). We compared the collapse rate and the visual analog scale (VAS) score immediately after the trauma and at the 1-week, 3-week, 6-week, and 1-year follow-ups. Results: The three abovementioned groups consisted of 89 patients, 60 patients, and 53 patients, respectively. The bone mass density (BMD) score of group 1 was statistically significantly higher than that of the others (p<0.05). In group 2, the average VAS score was high immediately after the trauma and low at the 1-year follow-up. Only group 2 showed a significantly high vertebral compression rate immediately after the trauma (p<0.05). Although there were no statistically significant differences in the incidence between the adjacent and the non-adjacent vertebral compression fractures, more patients underwent additional VP in groups 2 and 3 (p= 0.980). Conclusion: The treatment method of performing EVP seems to yield the best clinical outcomes for patients with osteoporotic compression fractures who exhibit a relatively low BMD, high collapse rate, and high VAS score. Conservative management is the treatment of choice for osteoporotic compression fracture patients with a relatively high BMD, low collapse rate, and low VAS score.

Study Design: Retrospective analysis. Objectives: To analyze the usefulness of Zero-P® by analyzing the radiological and clinical outcomes with a minimum of 2 years of follow-up. Summary of Literature Review: Anterior discectomy and fusion (ACDF) using Zero-P® showed excellent results. However, there is a lack of studies focusing on long-term outcomes. Materials and Methods: Ninety-eight patients who underwent single-level ACDF using Zero-P® with more than 2 years of follow-up were included for analysis. In the radiological analysis, we evaluated disc height, segmental lordosis, and subsidence in the preoperative, postoperative, and last follow-up periods. The Neck Disability Index (NDI), Neck Visual Analogue Scale (VAS), and Arm VAS were also evaluated for clinical assessment. Radiological bony fusion was assessed, and radiological and clinical differences according to bony fusion were evaluated. Results: Intervertebral disc height had increased 2.92 mm after surgery and subsided to 2.36 mm at the final follow-up. Subsidence of the screw was 0.58 mm at final follow-up. Segmental lordosis was 3.97° at the preoperative assessment, 8.39° in the postoperative follow-up, and 5.83° in the last follow-up. The Neck VAS score was 4.47, 2.28, and 1.27, respectively. The Arm VAS score was 5.73, 3.13, and 2.18; and NDI score was 17.8, 11.7, and 7.89, respectively. There was no association between the radiological and clinical results. Radiological nonunion was found in 18 subjects. There were no significant differences in radiological and clinical parameters according to bony union. Conclusions: ACDF with Zero-P® for treatment of degenerative cervical disease showed subsidence in 55.1% and nonunion in 18% of cases. However, the radiological results were not related to the clinical results.

Study Design: Retrospective study. Objectives: To evaluate how the timing of pedicle screw fixation (early or late) in pyogenic spondylitis relates to the period of hospitalization, duration of intravenous antibiotic use, and recurrence of infection and to confirm the efficacy of early pedicle screw fixation for pyogenic spondylitis. Summary of Literature Review: Intravenous antibiotics and surgery including debridement and fixation are used as a treatment option for pyogenic spondylitis. Materials and Methods: We retrospectively reviewed 31 patients who underwent posterior decompression and pedicle screw fixation with intravenous antibiotic treatment for pyogenic spondylitis from November 2005 to February 2015. We divided the study group into an early fixation group, whose instrumentation was inserted no later than 15 days after antibiotic therapy, and a late fixation group for cases who underwent the procedure 15 days or more after antibiotic therapy. We compared the period of hospitalization and intravenous antibiotic treatment, the rate and period of the prescription of oral antibiotics, and the rate of recurrence or reoperation. Results: The period of hospitalization and intravenous antibiotic treatment of the early fixation group (55 and 43.4 days) were significantly shorter than those of the late fixation group (85 and 67.1 days). The rate and period of the prescription of oral antibiotics were not significantly different between the two groups. There was no case of recurrence or reoperation in either group. Conclusions: Early fixation using pedicle screws for pyogenic spondylitis reduces the period of hospitalization and intravenous antibiotic treatment compared to late fixation.