Effectiveness of Posterior Long-Segment Fixation for Thoracolumbar Osteoporotic Compression Fractures: A Retrospective Study

Objective: This retrospective cohort study aimed to evaluate the effectiveness of posterior long-segment fixation for thoracolumbar osteoporotic vertebral compression fractures (TLOVCFs) and identify prognosis-predicting factors.

Methods: Twenty-two patients with TLOVCFs who underwent posterior long-segment fixation between January 2013 and June 2022 were included. Preoperative, postoperative, and final follow-up data were collected, including demographics, bone mineral density, Cobb angle (CA) measurements, and neurological outcomes based on the Frankel classification. The study compared the outcomes of percutaneous versus open screw fixation methods, focusing on radiologic parameters, surgical complications, and neurological improvement.

Results: The mean patients' age was 71.9 ± 10.2 years, with a mean follow-up duration of 1383.3 ± 1026.1 days. The CA showed significant improvements, decreasing from a preoperative mean of 27.1° ± 6.8° to a postoperative mean of 17.0° ± 5.9° and maintaining at 20.9° ± 6.7° at the final follow-up. Neurological improvement was noted in 95.4% of patients. Screw loosening was observed in 27.3% of patients, without significant differences between the groups. However, the open surgery group showed less CA progression compared to the percutaneous group.

Conclusions: Posterior long-segment fixation effectively improved kyphotic deformity and provided stable outcomes in patients with TLOVCFs. Open screw fixation offered better maintenance of correction with a lower risk of screw loosening compared to percutaneous methods. Therefore, further prospective studies are necessary to establish standardized treatment protocols for TLOVCFs.