![]() ![]() However, this classification system is mainly applicable to high-energy fractures, not suitable for OVCF characterized by low-energy damage. In 2013, AO proposed improved AO classification on the basis of the original, and comprehensively evaluated fracture classification from three aspects: morphological classification, neurological status and clinical correction index. In addition, this classification does not reflect the severity and characteristics of osteoporotic fractures. further improved and proposed the Heini classification according to clinical and imaging findings, but there was crosses overlap between different types, which was not conducive to clear clinical guidance. proposed the EVOSG classification and divided the OVCF into three types: wedge type, double concave type and collapse typ, but there is no classification of nerve damage. proposed the Genant semi-quantitative method for fractures with different symptoms. Therefore, in the face of old fractures, we should choose reasonable surgical methods to avoid further compression of the fractured vertebrae, aggravating kyphosis, and damaging the spinal nerves. In more severe cases, it can cause nerve damage. Pseudarthrosis is also known as fracture nonunion, refers to the fracture end under the influence of certain conditions, fracture healing function stops, the fracture end has formed pseudarthrosis. In addition, 14% of patients will develop pseudarthrosis. The possible reason for the long-term pain at the fracture site is that the fractured vertebra is always in a state of continuous compression due to long-term activities, and the fractured vertebra is slightly displaced, which constantly stimulates the peripheral nerves of the vertebra. Vertebral compression fractures are the most common complication of spine osteoporosis, which can cause pain at the fracture site and loss of the vertebral body, and can lead to later kyphosis. For old OVCF, conservative treatment, such as bed rest, wearing braces, anti-osteoporosis and other drug treatment, has no obvious effect on most patients. Moreover, most elderly patients are not sensitive to pain, which may easily delay the disease and eventually develop into old fractures. As OVCF is a kind of low-energy damage, post-injury pain is easily confused with fatigue pain. It has been reported that the prevalence of vertebral fracture in women over 50 years old is about 15%, and that in women over 80 years old is up to 36.6%. This provides clinical reference and guidance for the treatment of symptomatic old OVCF in the future.Īs the population ages, osteoporotic vertebral compression fractures (OVCF) are increasing, as are acute and chronic pain episodes and progressive spinal deformities. In this study, we concluded that graded surgery could better treat symptomatic old OVCF and restore spinal stability. Besides, the postoperative ASIA grades of 16 patients with nerve injury were improved from 14 patients with preoperative grade C, 2 patients with grade D to 4 patients with postoperative grade D and 12 patients with postoperative grade E. ![]() After graded surgery, the VAS score, ODI score, and vertebral sagittal index SI of 238 patients were significantly improved, and the difference between the last follow-up results and the preoperative comparison was statistically significant ( P ˂ 0.05). ResultsĪll 238 patients were followed up for 12–38 months, with an average follow-up of 18.5 months. Postoperative visual analog score (VAS), oswestry disability index (ODI) scores, sagittal index (SI) and ASIA grades of neurological function were observed. I, old vertebral fracture with no apparent instability, vertebral augmentation II, old vertebral fracture with local instability, posterior reduction fusion internal fixation III, old fractures with spinal stenosis, posterior decompression and reduction fusion and internal fixation IV, old vertebral fracture with kyphosis, posterior osteotomy with internal fixation and fusion V, a mixture of the above types, posterior osteotomy (decompression) with internal fixation and fusion. ![]() According to clinical characteristics and imaging examinations, these patients were divided into I-V grades and their corresponding surgical methods were developed. We retrospectively analyzed 238 symptomatic OVCF patients who entered our hospital from June 2013 to 2016. Therefore, this study aims to explore the surgical approaches for the treatment of OVCF with different symptoms and evaluate the feasibility of these surgical approaches. However, there are no clear surgical treatment criteria for patients with these different symptoms. Symptomatic osteoporotic vertebral compression fractures (OVCF) are increasing, as are acute and chronic pain episodes and progressive spinal deformities. ![]()
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