Efficacy of pedicle screw fixation and vertebroplasty treatment of severe osteoporotic thoracolumbar vertebral compression fractures in senior patients

Objective: Osteoporotic thoracolumbar compression fractures have become an important public health problem due to population aging. This study aimed to assess the efficacy of percutaneous pedicle screw fixation combined with vertebroplasty for severe osteoporotic thoracolumbar compression fractures in senior patients. Methods: Twenty-seven patients who had been diagnosed with osteoporotic thoracolumbar compression fractures without neurological deficits underwent percutaneous pedicle screw fixation combined with vertebroplasty. Polymethylmethacrylate bone cement was used. Visual analogue scale (VAS) scores, Cobb angles, and anterior column height were assessed before and after the operation. The patients returned for clinical evaluations 1, 3, 6, 12, and 24 months after surgery. Results: The mean follow-up period was 24.11 +/- 1.23 months. The mean VAS score decreased significantly, from 6.98 +/- 1.31 preoperatively to 2.52 +/- 1.64 postoperatively to 0.72 +/- 1.66 at the two-year follow-up (P < 0.001). The mean Cobb angle was 41.38 degrees +/- 4.18 degrees before surgery, 25.41 degrees +/- 2.67 degrees after the operation, and 27.98 degrees +/- 2.76 degrees (P < 0.001) at the two-year follow-up. The average increase in vertebral body height was 8.14 mm anteriorly. No complications, such as infections or neurological impairments, were observed, and there was no bone cement leakage. Conclusions: Percutaneous pedicle screw fixation combined with vertebroplasty provides a safe and effective option for the treatment of severe osteoporotic thoracolumbar compression fractures in senior patients.