| Clinical Analysis of Thoracolumbar Compression
Fracture in the Elderly Patients |
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Jeong Ho Kim , Chang Hwa Choi |
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Department of Neurosurgery, Pusan National University School of Medicine, Busan, Korea |
| 노인환자에서 흉요추부 압박골절의 임상 분석 |
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| Abstract |
Objective
Compression fracture of the vertebral body is common, especially in the elderly patients. Osteoporosis
is one of the main risk factor of vertebral compression fracture. Traditional conservative treatment includes bed
rest, pain control, and physical therapy. But, interventional procedure such as vertebroplasty can be considered
in those who do not respond to conservative therapy. We report our experiences about vertebral compression
fracture in the elderly patients.
Material and Methods: We reviewed the clinical and radiologic data in 33 patients with symptomatic compression
fracture of the vertebral body from January 2001 to December 2004. They have categorized into three groups
determined by age (group A 50～59, group B 60～69, group C more than 70). Group A were 5, Group B were
13, Group C were 15. Bone mineral densitometry was performed in all patients. The ratio of height loss in compression
fracture of the vertebral body was calculated in all patients. Percutaneous vertebroplasty was used in 13 patients
(1 group A and 6 group B and 6 group C). The remaining 20 patients received conservative treatment. The mean
follow-up period was 12 months (from 6 to 27).
Results
The most common cause of fracture was slip down and the most common site of vertebral compression
was T12 in women and L1 in men. Mean T score of bone mineral density (BMD) was measured -1.58 in group A (range
0～-2.8), -2.65 in group B (-1.0～-3.8), and -2.88 in group C (-1.3~-4.6). The mean ratio of height loss in compression fracture
of the vertebral body was calculated 21.54% in group A, 29.81% in group B, and 33.91% in group C at initial diagnosis.
Their mean increasing ratio of height in the vertebral body was 0.95% in group A, 2.12% in group B, and 2.81%
in group C who performed percutaneous vertebroplasty, but mean increasing ratio was 4.14% in group A, 6.07%
in group B, and 12.21% in group C who did not performed percutaneous vertebro- plasty. In the follow-up study, degree
of decrease in back pain showed better results in patients with vertebroplasty than in patients with conservative
treatment.
Conclusion
Thoracolumbar compression fracture is common in the elderly patients with osteoporosis. The vertebral
BMD was decreased as patients grew older. The lower T score of BMD were, the more increased height loss ratio
of vertebral body was. The height loss ratio of vertebral body was more increased in patients without percutaneous
vertebroplasty than in patients with it. Thus, percutaneous vertebroplasty is considered a valuable procedure to
prevent progression of height loss in the treatment of vertebral body compression in the eldely patients. |
| Key Words:
Compression fractureㆍVertebroplastyㆍElderly patientsㆍHeight lossㆍOsteoporosis |
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