To evaluate our results of treatment of kyphosis following osteoporotic fractures of the last 3 years. 28 women with a mean age of 63,2 years were treated for a painful kyphotic deformity of a mean Cobb angle 76,1°. They all had posterior fusion with pedicular screws and rods enhanced with autologous bone graft as well as allografts. Cement augmentation was used in a number of screws. A cell saver for auto transfusion and continuous neurophysiological monitoring was used intraoperatively in all cases. All patients fitted with a thoracolumbar brace for 3 months. The postoperative mean Cobb angle was 45,2° (40,6% improvement). Pain questionnaires at a mean postoperative follow up of 16 months showed excellent results in 10 patients (35,71%), good in 8 patients (28,57%), satisfactory in 6 patients (21,42%) and poor results in 4 patients (14,28%). All patients were satisfied with the cosmetic result. 2 patients presented a postoperative infection that was treated with debridement and antibiotics. Kyphotic deformity following osteoporotic fractures may treated satisfactory with rods and pedicular screws with cement augmentation
The documentation of the results of combined anterior -posterior approach in the treatment of spinal tumors in our department. A total of 28 patients (16 men – 12 women) aged 15 to 75 year old (mean age = 54 years) were treated. Of those 7 presented with a benign primary tumor and 21 with malignancies of which 15 were metastatic. 16 patients had a neurologic deficit but met the international criteria for surgical intervention. The staging of the tumors and their postoperative care was undertaken by a tumor centre. All patients underwent posterior decompression with laminectomy, resection of all posterior elements including part of the pedicle, excision of the tumor and posterior stabilization. This was followed at the same operative session by an anterior approach (transthoracic, transperitoneal or anterior cervical) corpectomy of the affected vertebrae and implantation of interbody cages secured with an anterior plate and screws in the healthy vertebrae. 7 patients improved neurologically following the operation while 9 had no change of their clinical condition. Perioperative complications were recorded in 5 patients. In 3 cases a dural tear was dealt with direct closure and 3 infections had to have surgical debridement at another stage and antimicrobial therapy. The treatment of spinal tumors with combined anterior-posterior approach in one session for a radical excision of the tumor is a demanding procedure