Abstract: Introduction: The International Osteoporosis Foundation has estimated that worldwide, approximately 30%-50% people aged over 50 years are at risk for the development of fragility fractures secondary to osteoporosis. Vertebral compression fractures occur in 20% of people over the age of seventy years and in 16% of postmenopausal women.
The majority of fractures heal with conservative treatment after 8 to 10 weeks. Surgery is indicated for patients who present with neurological deficits, deformities, and incapacitating pain with conservative treatment failure.2% of patients with OVFs develop cord compression.
This study aimed to identify the clinical presentation and predictors of clinical outcomes among patients operated for delayed neurological deficits after OVFs.
Materials and methods
8 cases – 5 female, 3 male,
Dorsolumbar junction – 7 cases, dorsal spine 1 case.
Neurological status
ASIA B – 1
ASIA C – 5
ASIA D – 2
All cases underwent posterior short segment fixation (pedicle screws one level above and below the fracture vertebra) and percutaneous vertebroplasty and indirect decompression.
Results and analysis: The average time to onset of neurological deficits was 5.4 weeks from the time of injury. Postoperatively neurology improved upto ASIA grade E – 7, grade D – 1. All patients were followed up with neurological assessment every 2 weeks upto 3 months and every month upto 6 months One patient could not walk, and seven patients walked with heavy assistance. Two patients had sphincter disturbance. The mean preoperative Baba's score was 5.96. The mean values of LAH (lateral anterior vertebral body height) and LPH (lateral posterior vertebral body height) were 41.0% and 60.7% postoperatively and 37.4% and 58.8% after 6 months post op. The average retropulsion was 36.5%.
Conclusion: Although OVFs are common and generally considered benign, severe and delayed neurological deficits can occur following spinal cord compression. Improved clinical outcomes are associated with compression fractures, less initial retropulsion, lack of surgical complications, and an optimal restoration of retropulsion.
