Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Spine
Abstract number: 24182
POSTERIOR SPINAL SHORTENING FOR DELAYED PARALYSIS AFTER
OSTEOPOROTIC SPINAL FRACTURE -PEDICLE SUBTRACTION OSTEOTOMY
AND MODIFIED POSTERIOR LUMBAR INTERBODY FUSION (PLIF) -
Takashi CHIKAWA, Tateaki SHIMAKAWA, Shunji NAKANO, Masaru NAKAMURA,
Risa UTSUNOMIYA
Department of Orthopaedic Surgery, Tokushima Municipal Hospital, Tokushima
(JAPAN)
[Purpose] To report the results of the posterior spinal shortening using claw hook and
pedicle screw for delayed paralysis after osteoporotic spinal fracture. [Subjects]
Subjects were 8 patients (4 male, 4 female) who received posterior spinal shortening
at our institutions in 2008. Their ages were between 63 and 78 (mean age 72.0
years), and the level of the fracture was Th7, Th9, Th12, L2 (1 case each), and L1
(4cases). [Method] We conducted posterior reconstruction by removing unstable
cranial disc and end plate with the modified PLIF and posterior shortening with
pedicle subtraction osteotomy. Basically, pedicle screws were inserted into 2
craniocaudal vertebras, and the reconstructed area was reinforced by claw hooks
and/or a tapes. The local kyphosis, bone union, and complications were investigated.
[Results] Mean preoperative local kyphosis was 11.8 degree, and it improved to 2.0
degrees after the operation. The loss of correction was very small in the mean of
approximately 3.2 degrees. So-called adding on fracture was observed in 2 cases.
There was no instrument failure, and bone union was observed in all cases. All cases
with existing gait impairment, pain, and bladder disturbance showed improvement
after the operation. Neurological findings in all cases had obviously improved by
Frankel grade. [Conclusion] The circumferential fusion by the anterior reconstruction
with the modified PLIF and posterior shortening stabilization and PLF was clinically
effective. Even in the osteoporotic spine, appropriate correction and fusion was
achieved by pedicle screw system with additional claw hook placement.
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