Osteoporotic vertebral collapse with late neurological complications

Area of Science:

• Orthopedics
• Neurosurgery
• Geriatric Medicine

Background:

• Osteoporotic vertebral collapse can lead to delayed neurological compromise.
• Insignificant spinal fractures can precede delayed onset of neurological deficits.
• Vertebral instability and fragment retropulsion contribute to spinal canal compromise.

Purpose of the Study:

• To describe the clinical course and surgical management of patients with delayed neurological compromise secondary to post-traumatic osteoporotic vertebral collapse.
• To evaluate surgical outcomes for anterior or posterior spinal decompression with or without instrumentation.
• To recommend an optimal surgical approach for this specific patient cohort.

Main Methods:

• Retrospective review of 27 patients (5 males, 22 females) with spinal fractures and subsequent delayed neurological compromise.
• Surgical intervention included anterior or posterior spinal decompression, with or without spinal instrumentation.
• Average follow-up duration was 3.7 years.

Main Results:

• Patients experienced delayed neurological compromise 1 month to 1.5 years post-fracture.
• Abnormal hypermobility and fragment retropulsion into the spinal canal were identified as contributing factors.
• Surgical treatment via anterior or posterior decompression was performed.

Conclusions:

• Transpedicular posterolateral decompression and stabilization with a screw-rod construct is recommended.
• This technique offers technical ease and minimal invasiveness.
• Effective surgical management can address late neurological deficits in osteoporotic vertebral collapse.