[Surgical treatment for osteoporotic spinal fractures in the thoraco-lumbar spine]

Most of osteoporotic spinal fractures can be successfully treated with conservative treatment. In some patients, however, conservative treatment is not effective and progressive vertebral collapse with neurological problems at thoraco-lumbar spine may occur. In this chapter, surgical indication and timing in patients with osteoporotic vertebral collapse are described. Surgical options including vertebroplasty, kyphoplasty, anterior reconstruction, posterior reconstruction, and combined anterior and posterior surgery are also described. The readers can understand both advantages and disadvantages of each surgical procedure. In senile patients, preoperative general conditions including comorbid medical problems should be taken into account to determine surgical treatments. Rigid and long spinal fusion using metal implants may lead to spinal fractures at adjacent vertebral bodies to the fused segments.