A complex management pathology: treatment experience of osteoporotic fractures in a reference Hospital in Peru
DOI:
https://doi.org/10.59156/cjm2qh89Keywords:
Lower back pain, Minimally invasive surgery, Osteoporotic fractures, VertebroplastyAbstract
Background: osteoporotic vertebral fractures (OVFs) are common in the elderly population, particularly at the thoracolumbar level. They are gaining relevance due to the global demographic transition, which involves an increase in this age group.
Objectives: to describe the pre- and post-surgical outcomes of patients treated for OVF and to compare these findings with the related published literature.
Methods: medical records of patients with OVF who underwent surgical treatment at our institution between 2022 and 2024 were reviewed. Vertebroplasty was performed in 18 cases, cemented fixation in 1 case, and cemented fixation plus corpectomy in 1 case. The AO Spine classification was used to classify OVFs, the VAS scale was used to assess pain, and the Oswestry scale was used to assess functionality. Statistical analysis was conducted using SPSS®.
Results: 20 patients with a mean age of 72.55 years were included; 18 presented with OF3–OF4 fractures. The most common fracture site was the thoracolumbar junction with 13 cases. There were 18 percutaneous vertebroplasties, 1 cemented fixation, and 1 cemented fixation plus corpectomy. The preoperative VAS score: 7.8, and postoperative: 1.7, showing an 80.2% reduction. The Oswestry score improved from 71.5 to 63.3. There were no immediate complications. The average hospital stay was 3 days (range: 1 to 90 days).
Conclusion: percutaneous vertebroplasty is a safe and effective treatment for thoracolumbar OVFs, providing significant pain relief and a low complication rate. In elderly patients, being minimally invasive optimizes clinical outcomes.
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References
1. Capdevila-Reniu A, Navarro-López M, López-Soto A. Fracturas vertebrales osteoporóticas: un reto diagnóstico en el siglo XXI. Rev Clin Esp. 2021;221(2):118-24. Disponible en: http://dx.doi.org/10.1016/j.rce.2019.09.006
2. Löffler MT, Kallweit M, Niederreiter E, Baum T, Makowski MR, Zimmer C, Kirschke JS. Epidemiology and reporting of osteoporotic vertebral fractures in patients with long-term hospital records based on routine clinical CT imaging. Osteoporos Int. 2022;33(3):685-94. Disponible en: http://dx.doi.org/10.1007/s00198-021-06169-x
3. Checa-Betegón P, Luque-Pérez R, y col. Fracturas vertebrales osteoporóticas: historia natural e impacto. Rev Esp Cir Ortop Traumatol. 2024;68(6):T587-96. Disponible en: http://dx.doi.org/10.1016/j.recot.2024.08.003
4. Tomé-Bermejo F, Bartolomé-Gómez JF. Factores anatómicos y biomecánicos de la fractura vertebral osteoporótica y la aparición de las fracturas en cascada. Rev Esp Cir Ortop Traumatol. 2024;68(6):562-71. Disponible en: http://dx.doi.org/10.1016/j.recot.2024.06.012
5. Schnake KJ, Blattert TR, y col. Classification of osteoporotic thoracolumbar spine fractures: Recommendations of the Spine Section of the German Society for Orthopaedics and Trauma (DGOU). Global Spine J. 2018;8(2 Suppl):46S-49S. Disponible en: http://dx.doi.org/10.1177/2192568217717972
6. Scherer J, Joaquim A, y col. AO Spine-DGOU Osteoporotic Fracture classification system: Internal validation by the AO Spine Knowledge Forum Trauma. Global Spine J. 2024;21925682241288187. Disponible en: http://dx.doi.org/10.1177/21925682241288187
7. Lamo-Rovira JD, Cebrián-Parra JL, Francés-Borrego A, y col. Tratamiento de las fracturas vertebrales mediante cifoplastia. Rev Esp Cir Ortop Traumatol. 2008;52(1):15-20. Available from: https://www.elsevier.es/es-revista-revista-espanola-cirugia-ortopedica-traumatologia-129-articulo-tratamiento-las-fracturas-vertebrales-mediante-13115871
8. Prost S, Pesenti S, Fuentes S, Tropiano P, y col. Treatment of osteoporotic vertebral fractures. Orthop Traumatol Surg Res. 2021;107(1S):102779. Disponible en: http://dx.doi.org/10.1016/j.otsr.2020.102779
9. Spiegl U, Bork H, Grüninger S, Maus U, Osterhoff G, y col. Osteoporotic fractures of the thoracic and lumbar vertebrae: Diagnosis and conservative treatment. Dtsch Arztebl Int. 2021;118(40):670-7. Disponible en: http://dx.doi.org/10.3238/arztebl.m2021.0295
10. Prajapati HP. Thoracolumbar junction fracture: Principle of management. Indian J Neurotrauma. 2021;18(02):126-32. Disponible en: http://dx.doi.org/10.1055/s-0040-1717211
11. Burguet Girona S, Ferrando Meseguer E, Maruenda Paulino JI. Opciones de tratamiento quirúrgico mínimamente invasivo en las fracturas vertebrales osteoporóticas OF4. Rev Esp Cir Ortop Traumatol. 2022;66(2):86-94. Disponible en: http://dx.doi.org/10.1016/j.recot.2021.07.009
12. Droguett Mallea M, Correa Valencia C, López Allendes R, Contreras Salazar D, y col. Instrumentación de fractura osteoporótica tóracolumbar: experiencia local y revisión de la literatura. Rev Chil Neurocirugía. 2022;48(1):9-18. Disponible en: https://www.revistachilenadeneurocirugia.com/index.php/revchilneurocirugia/article/view/341/199
13. Mo Lee H, y col. Comparative analysis of clinical outcomes in patients with osteoporotic vertebral compression fractures (OVCFs): conservative treatment versus balloon kyphoplasty. Spine J. 2012;12(11):998-1005. Disponible en: http://dx.doi.org/10.1016/j.spinee.2012.08.024
14. Santiago Maniega S, Crespo Sanjuán J, Ardura Aragón F, y col. Verdades y mentiras de las técnicas de cementación en el tratamiento de las fracturas por fragilidad. Rev Esp Cir Ortop Traumatol. 2024;68(6):597-606. Disponible en: http://dx.doi.org/10.1016/j.recot.2024.04.007
