Kyphosis with osteoporotic compression fracture

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Presentation transcript:

Kyphosis with osteoporotic compression fracture

Diagnosis & Pathophysiology of T11 fracture ? Various terminologies for this kind of vertebral body fracture ? Pathomechanism of this kind of vertebral body fracture? Risk factors for this kind of vertebral body fracture? Natural course of this type of fracture?

Preoperative consideration & work-up What should we consider preoperatively? Main symptom Extent of kyphosis Neural compression Rigidity of deformity Bone density Which kind of Work up should be done for patients? Symptomatic evaluation for osteoporotic comp. fracture : nature of back pain : neurologic symptoms, progressive neurologic deficit : deformity Medical condition : poor physical function d/t pain, fear dependency, depression, : How to evaluate surgical risk & benefit? Bone density: poor fixation, adjacent vertebral fracture Imaging studies (initial deformity, degree of instability) : flexion-extension : Cobb’s angle, SVA : progression of kyphosis, progression of collapse -- mechanism of progression Neuromonitoring

Which kind of treatment for this type of fracture? Conservative, interventional or surgical Tx.? : Brace, medication : VP, KP necessary ? When should we consider to start surgical treatment? Extent of surgical approach : stabilization in situ, deformity correction, neural decompression (corpectomy, laminectomy) Surgical options : anterior, anterior-post. Posterior only Advantages & Indications of each options

Complications: prevention & treatment Complications of conservative Tx. VP, KP Complications of surgical Tx. Instrumentation failure : causes of instrumentation failure : Methods to increase the fixation power PJF DJF Causes of DJF & how to avoid DJF