Clinical Effect of Vertebral Column Decancellation Osteotomy Combined with Ponte Osteotomy in Elderly Patients with Old Thoracolumbar Fracture Combined with Kyphosis Deformity

2021 ◽  
Vol 7 (5) ◽  
pp. 3878-3887
Author(s):  
Tongtong Zhang ◽  
Chao Kong ◽  
Xiangyao Sun ◽  
Wei Wang ◽  
Shudong Jiang ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Cobb Angle ◽  
Vertebral Column ◽  
Clinical Effect ◽  
Life Quality ◽  
Thoracolumbar Fracture ◽  
Thoracolumbar Kyphosis ◽  
Ponte Osteotomy ◽  
Vas Score

Objective. The purpose of this study was to investigate the clinical effect of vertebral column decancellation (VCD) osteotomy combined with Ponte osteotomy in elderly patients withold thoracolumbar fracture combined with kyphosis deformity.Methods.36 elderly patients with old thoracolumbar fracture combined with kyphosis deformity admitted to our hospital from August 2015 to November 2018 were selected as the study subjects, and all of them were treated with VCDosteotomy combined with Ponte osteotomy.The Cobb angle of thoracolumbar kyphosis, sagittal vertical axis (SVA), visual analog scale (VAS) score.Oswestry disability index (ODI) and life quality were compared at 1 week before and after surgery as well as at the last follow-up. Results. ® All the 36 patients underwent the surgery successfully without serious complications, with the average duration of surgery of (5.13±0.62) h, average blood loss of (821.58±142.67) ml and average hospital stay of (14.02±2.43) d. (2) The Cobb angle of thoracolumbar kyphosis and SVA at 1 week after surgery and at the last follow-up were smaller than those at 1 week before surgery (P < 0.01), but the Cobb angle of thoracolumbar kyphosis and SVA at the last follow-up were slightly larger than those at 1 week after surgery (P < 0.01). (3) The VAS score and ODI score at 1 week after surgery and at the last follow-up were lower than those before surgery (P < 0.01), and the VAS score and ODI score at the last follow-up were lower than those at 1 week after surgery (P < 0.01). @ The scoliosis research society 22-item (SRS-22) score at the last follow-up was higher than that before surgery (P < 0.01). Conclusion. VCD osteotomy combined with Ponte osteotomy in the treatment of old thoracolumbar fracture combined with kyphosis deformity in the elderly can reduce the Cobb angle of thoracolumbar kyphosis, improve sagittal balance, reduce pain symptoms and functional disorders, and improve patents’ life quality, having a good clinical effect.

scholarly journals Clinical effect of using MultiLoc® nails to treat four-part proximal humeral fractures

2020 ◽  
Vol 48 (12) ◽  
pp. 030006052097921
Author(s):  
Zhaofeng Jia ◽  
Chuangli Li ◽  
Jiandong Lin ◽  
Qisong Liu ◽  
Guangheng Li ◽  
...  
Keyword(s):  
Fracture Healing ◽  
Clinical Effect ◽  
Operation Time ◽  
Shoulder Function ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Fixation Method ◽  
Vas Score ◽  
Surgical Fixation

Objective This study was performed to evaluate the clinical effect of MultiLoc® nails (DePuy Synthes, Raynham, MA, USA) on the treatment of four-part proximal humeral fractures (PHFs). Methods From January 2014 to January 2018, 32 patients with four-part PHFs were treated with intramedullary MultiLoc® nails in our hospital. The operation time, bleeding volume, postoperative X-ray findings, and fracture healing status were recorded and analyzed. At the end of follow-up, the clinical outcome was evaluated based on the visual analog scale (VAS) score, American Shoulder and Elbow Surgeons (ASES) shoulder score, Constant–Murley score (CMS), and occurrence of any complications. Results Among all patients, the average operation time was 124.5 minutes (range, 91–152 minutes), the average amount of bleeding was 90 mL (range, 55–150 mL), and the fracture healing rate was 100%. At the end of follow-up, the mean VAS score was 1.6 ± 0.4, mean ASES score was 84.4 ± 6.3, and mean CMS was 70.3 ± 6.1; no serious complications had occurred; and the patients exhibited good recovery of shoulder function. Conclusions MultiLoc nails® can be applied to the treatment of four-part PHFs. This surgical fixation method has no obvious complications and helps to restore shoulder function.

scholarly journals EVALUATE THE PHYSICALACTIVITY (MOBILITY-INDOOR,OUTDOOR) AND VAS SCORE OF TRANSPEDICULAR DECOMPRESSION AND INSTRUMENTED FUSION IN PATIENTS WITH THORACIC AND THORACOLUMBAR FRACTURE

2020 ◽  
pp. 40-41
Author(s):  
Sharad Panwar ◽  
Kk Pandey
Keyword(s):  
Physical Activity ◽  
Functional Outcome ◽  
Daily Life ◽  
Thoracolumbar Fracture ◽  
Instrumented Fusion ◽  
Vas Score ◽  
Walking Aids ◽  
Score Result ◽  
Excellent Improvement

AIMS & OBJECTIVES Evaluate the Physical activity (mobility-indoor,outdoor) and VAS score of Transpedicular decompression and instrumented fusion in patients with thoracic and thoracolumbar fracture . Method We include 30 patients and score was recorded from admission, preoperatively, immediate post operatively at the time of discharge and follow up period ( 1 month, 6 month, 1 year ) and evaluate the patients Physical activity (mobility-indoor,outdoor) and VAS score. Result In this study we found that there is gradual and excellent improvement in functional outcome in patients daily life . with the help of walking aids , wheelchair/ physiotherapy patients improve their routine lifestyle after undergo transpedicul decompression and instrumented fusion. In this study we found that there is gradual and excellent improvement in functional outcome in patients daily life .Mean mobility-indoor,outdoor is 1.4 in post op, 8.9 in 3 month, 14.23 at 6 month , 19.36 at 1 year and VAS score at pre op , post op , 3 month 6 month and 1 year is respectively 8 , 7.75 , 4.06 ,1.9 , and 1.23 .

Analysis of Clinical Effect of Interbody Fusion and Internal Fixation on Degenerative Scoliosis

2021 ◽  
Vol 7 (5) ◽  
pp. 1373-1377
Author(s):  
Lei Sun ◽  
Xiaoren Wang ◽  
Haifeng Guo ◽  
Dongwei Yang
Keyword(s):  
Internal Fixation ◽  
Cobb Angle ◽  
Interbody Fusion ◽  
Clinical Effect ◽  
Clinical Symptoms ◽  
Linear Regression Analysis ◽  
Adjacent Segment ◽  
Degenerative Lumbar Scoliosis ◽  
Degenerative Scoliosis

In this study, we analyzed the clinical effect of interbody fusion and internal fixation on degenerative scoliosis. Methods: After degenerative lumbar scoliosis (DLS) surgery, patients were retrospectively evaluated using VAS (Visual Analogue Scale) and ODI (Oswestry Disability Index) to evaluate clinical efficacy. All patients underwent posterior lumbar decompression laminectomy, pedicle screw internal fixation and posterolateral bone graft fusion.Imaging measurements include scoliosis Cobb angle, fusion Cobb angle, intervertebral angle (AIA), sagittal intervertebral angle (SIA), and lumbar lordosis angle. The relationship between these parameters was tested by binary Pearson analysis and linear regression analysis. Results: Before surgery, the Cobb angle of the scoliosis segment was 15.3°, and it dropped to 10.1° immediately after the operation (P <0.05). Compared with preoperative and postoperative values (2.4°2.7 and 2.1 °2.3, respectively; P <0.05), AIA increased significantly (4.3°3.3) at the last follow-up. However, scoliosis Cobb angle and AIA were not related to VAS or ODI scores. At the final follow-up, no patients developed pseudoarthritis or internal device-related complications. Conclusion: Intervertebral bone fusion and internal fixation resulted in limited DLS correction, and the correction effect decreased over time. The AIA between the upper adjacent segment and the proximal fusion vertebrae continues to increase after surgery, but it does not worsen the clinical symptoms, which is reflected in the lower reoperation rate of the adjacent level of repair recurrence rate.

EFFICACY OF HEMIARTHROPLASTY FOR HUMERAL FOUR-PART FRACTURES IN ELDERLY

2020 ◽  
Vol 4 (7) ◽  
Author(s):  
Satish Bobade ◽  
Sandesh Bobade ◽  
Pravin Deokate
Keyword(s):  
Elderly Patients ◽  
Proximal Humerus ◽  
Humeral Fracture ◽  
The Elderly ◽  
Disability Score ◽  
Lesser Tuberosity ◽  
Factors Affecting ◽  
Vas Score ◽  
Number Of Patients

Background: There are four anatomic parts of the proximal humerus namely, head, greater tuberosity, lesser tuberosity, and surgical neck. 140 ͦ is the approx angle that is formed by the neck-shaft of the humeral. With prevalence rate of 5-6% among the elderly its incidence increase with the advancement in the age.  There are various factors affecting this advancement of the elderly patients towards the proximal humerus including increasing age, osteoporosis, age, sex and other similar factors. Aim: To study the efficacy of Hemiarthroplasty for Humeral Four-part Fractures in Elderly Patients Methods: It was an observational study. 30 patients were taken up for the study, who were diagnosed with humeral fracture. All the patients were included in the study after getting written consent from them. Radiography was done for all the patients from an AP view, a lateral shoulder view in the scapular plane, and of the axilla according to the Neer’s classification. Results: The above table shows that the number of patients was 10 and that of the female patients was 20. The mean age for the patients was 75.45±10.69 years. The VAS score before treatment was found to be ranged from 50-90 and the VAS score after treatment was found to be ranged from 75-95. The above table shows that the VAS pain was 20 in 3 months follow up time that increased to 25 in 1 year follow up time. The VAS disability score within 3 months follow up was 53 that reduced to 47 in 1 year follow-up period. The CMS activity score was in 3 months follow-up was 10.5 and that in 1 year follow up was 15. The CMS mobility after 3 months follow-up was 13 that increased to 22 in 1 year follow-up period. Conclusion: In the light of above results and discussion it is evident that the Hemiarthroplasty is a more viable option for reducing pain and increasing mobility in elderly patients suffering from four-part humeral fracture as compared to any other operative technique.

Outcomes, Complications, and Technical Aspects of One-Level Vertebral Column Decancellation Osteotomy for Thoracolumbar Kyphosis in Ankylosing Spondylitis: Experience of 39 Patients with Minimum 2-Year Follow-Up

2020 ◽  
Author(s):  
Zhijun Xin ◽  
Guoquan Zheng ◽  
Xinwen Feng ◽  
Peng Huang ◽  
Xuesong Zhang ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Blood Loss ◽  
Vertebral Column ◽  
Perioperative Complications ◽  
Operation Time ◽  
Clinical Results ◽  
Kyphotic Deformity ◽  
Thoracolumbar Kyphosis ◽  
Complete Paralysis

Abstract Objective To evaluate the safety and efficacy of one-level vertebral column decancellation (VCD) for the correction of thoracolumbar kyphosis in ankylosing spondylitis (AS) will beneficial for clarify the application of this procedure. Methods With a minimum 2-year follow-up, 39 AS patients with kyphotic deformity who underwent one-level VCD were retrospectively reviewed. The operation time, blood loss, and perioperative complications were investigated to evaluate the technical safety. Pre- and postoperative radiographic and clinical parameters were compared to evaluate the technical efficacy. Results All of the osteotomy sites were located between T12 and L3. With an average operation time of 257.8±49.9 minutes, the average blood loss was 596.1±218 ml. 4 patients (10.3%) experienced complications during the follow-up period, while no deaths or complete paralysis were occurred. With an average correction of 45.07±11.27° have obtained for one-level VCD, the radiographic parameters improved significantly from preoperative to postoperative, including global kyphosis (from 42.05±13.82° to 1.51±12.08°), local kyphosis (from 20.54±15.43° to -24.54±12.83°), lumbar lordosis (from -8.01±16.34° to -42.81±13.98°), and SVA (from 17.47±6.77 cm to 7.45±5.37). At final follow-up, the clinical results were significantly improved compared with the preoperative results, including VAS for back pain (from 6.82±0.91 to 0.15±0.37), CBVA (from 30.44±10.81° to 10.10±3.92°) and all items of SRS-22 questionnaire. Conclusion With an acceptable complication rate, one-level VCD is an effective technique which can provide an average correction of 45° for correcting kyphotic deformity caused by AS, and can achieve good results even for severe AS kyphosis with a necessary correction angular up to 60°.

scholarly journals Posterior Vertebral Column Resection (pVCR) for Severe Thoracolumbar Kyphosis in Patients With Achondroplasia

2021 ◽  
pp. 219256822198929
Author(s):  
Hai Wang ◽  
Shengru Wang ◽  
Nan Wu ◽  
Shujie Wang ◽  
Guixing Qiu ◽  
...  
Keyword(s):  
Surgical Complications ◽  
Vertebral Column ◽  
Neurological Complications ◽  
Thoracolumbar Kyphosis ◽  
Vertebral Column Resection ◽  
Posterior Vertebral Column Resection ◽  
Japanese Orthopedic Association ◽  
Cerebrospinal Fluid Leaks ◽  
Dural Tears

Study Design: Retrospective cohort study. Objective: We aimed to evaluate the safety and validity of posterior vertebral column resection (pVCR) for severe thoracolumbar kyphosis (TLK) in the achondroplasia (ACH) patients. Methods: Seven ACH patients (male: female = 6:1) who underwent pVCR procedures due to severe TLK from December 2008 to December 2017 in the authors’ hospital were included in this retrospective study. Their mean follow-up duration was 67 ± 35 months. Their clinical characteristics, radiologic characteristics, surgical characteristics and surgical complications were reviewed. Results: A total of 8 vertebrae were removed with an average of 5 ± 2 levels of decompression and 9 ± 2 segments instrumented. The mean correction rates of TLKs and the main curves were 73 ± 15% and 87 ± 6%, respectively. Five patients (71%) had preoperative neurological symptoms with a mean Japanese Orthopedic Association (JOA) score of 8 ± 3 points. Their neurological functions were all improved, with a recovery rate of 78 ± 32% for the JOA score at the last follow-up. Four patients (57%) suffered from surgical complications, including rod breakages (43%), neurological complications (28%), dural tears (14%), cerebrospinal fluid leaks (14%) and proximal junction kyphosis (14%). Conclusions: pVCR can offer a good correction for TLK and improve neurological function with extensive laminectomies in ACH patients. But the morbidity of surgical complications is relatively high. Therefore, it is a reserved surgical option for severe TLK in ACH patients by experienced spinal surgeons, especially with apical markedly hypoplastic vertebrae.

scholarly journals Biportal endoscopic posterior lumbar decompression and vertebroplasty for extremely elderly patients affected by lower lumbar delayed vertebral collapse with lumbosacral radiculopathy

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Min-Seok Kang ◽  
Dong-Hwa Heo ◽  
Hoon-Jae Chung ◽  
Ki-Han You ◽  
Hyong-Nyun Kim ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Clinical Outcomes ◽  
Anterior Column ◽  
Vertebral Collapse ◽  
Lumbosacral Radiculopathy ◽  
Vas Score ◽  
Lower Lumbar ◽  
Anterior Column Reconstruction ◽  
Cleft Formation

Abstract Background Lower lumbar osteoporotic vertebral compression fracture in extremely elderly patients can often lead to lumbosacral radiculopathy (LSR) due to delayed vertebral collapse (DVC). Surgical intervention requires posterior instrumented lumbar fusion as well as vertebral augmentation or anterior column reconstruction depending on the cleft formation and intravertebral instability. However, it is necessary to decide on surgery in consideration of the patient’s frail status, surgical invasiveness, and rehabilitation. In the lower lumbar DVC without intravertebral instability, biportal endoscopic posterior lumbar decompression and vertebroplasty (BEPLD + VP) can be simultaneously attempted. This study aimed to assess the clinical outcomes of BEPLD + VP for the treatment of DVC-related LSR. Methods This retrospective case series enrolled 18 consecutive extremely elderly (aged ≥ 75-year-old) patients (6 men and 12 women) who had lower lumbar (at or below L3) DVC-related LSR. Patients who require anterior column reconstruction, such as cleft formation accompanied by intravertebral instability and patients who have not been followed for more than 6 months, were excluded from this study. All patients underwent BEPLD + VP under epidural anesthesia. Clinical results were evaluated by the visual analog scale (VAS) score and the modified Japanese Orthopedic Association (mJOA) scores. Results Most of the patients had DVC affecting level L4, with the deformation being a flat type or concave type rather than a wedge type. The VAS score (back and leg) significantly decreased from 7.78 ± 1.17 and 6.89 ± 1.13 preoperatively to 2.94 ± 0.64 and 2.67 ± 1.08 within 2 postoperative days (p < 0.001). The mJOA score significantly improved from 4.72 ± 1.27 preoperatively to 8.17 ± 1.15 in the final follow-up (p < 0.001). The mean recovery rate (RR) in the last follow-up was 56.07% ± 9.98. Incidental durotomy was reported in two patients and epidural hematomas in another two patients; however, all patients improved with conservative treatment, and no re-operation was required. Conclusions BELPD + VP was a type of salvage therapy that reduces surgical morbidity, requires major spine surgery under general anesthesia and provides good clinical outcomes in extremely elderly patients with DVC-related LSR.

scholarly journals Congenital scoliosis treated with posterior vertebral column resection in patients younger than 18 years: longer than 10-year follow-up

2016 ◽  
Vol 25 (2) ◽  
pp. 225-233 ◽  
Author(s):  
Dong-Gune Chang ◽  
Jae Hyuk Yang ◽  
Jung-Hee Lee ◽  
Jin-Hyok Kim ◽  
Seung-Woo Suh ◽  
...  
Keyword(s):  
Cobb Angle ◽  
Vertebral Column ◽  
Congenital Scoliosis ◽  
Rigid Fixation ◽  
Vertebral Column Resection ◽  
Posterior Vertebral Column Resection ◽  
Time Of Surgery ◽  
The Mean

OBJECTIVE There have been no reports on the long-term radiographic outcomes of posterior vertebral column resection (PVCR) in patients with congenital scoliosis. The purpose of this study was to evaluate the surgical outcomes and complications after PVCR and its long-term effects on correcting this deformity in children with congenital scoliosis. METHODS The authors retrospectively analyzed the medical records of 45 patients with congenital scoliosis who were younger than 18 years at the time of surgery and who underwent PVCR and fusion with pedicle screw fixation (PSF). The mean age of the patients at the time of surgery was 11.3 years (range 2.4–18.0 years), and the mean length of follow-up was 12.8 years (range 10.1–18.2 years). RESULTS The mean Cobb angle of the main curve was 46.5° before PVCR, 13.7° immediately after PVCR, and 17.6° at the last follow-up. For the compensatory cranial curve, PVCR corrected the preoperative Cobb angle of 21.2° to 9.1° postoperatively and maintained it at 10.9° at the last follow-up. For the compensatory caudal curve, the preoperative Cobb angle of 23.8° improved to 7.7° postoperatively and was 9.8° at the last follow-up. The authors noted 22 complications, and the overall incidence of complications was 48.9%. CONCLUSIONS Posterior vertebral column resection is an effective procedure for managing congenital scoliosis in patients younger than 18 years. Use of PVCR and fusion with PSF for congenital scoliosis achieved rigid fixation and satisfactory deformity correction that was maintained over the long term. However, the authors note that PVCR is a technically demanding procedure and entails risks for major complications and excessive blood loss.

scholarly journals Percutaneous Vertebroplasty Versus Kyphoplasty for Thoracolumbar Osteoporotic Vertebral Compression Fractures in Patients with Distant Lumbosacral Pain

2021 ◽  
pp. E349-E356
Author(s):  
Qihang Su
Keyword(s):  
Cobb Angle ◽  
Oswestry Disability Index ◽  
Vertebral Compression Fracture ◽  
Percutaneous Vertebroplasty ◽  
Compression Fracture ◽  
Osteoporotic Vertebral Compression Fracture ◽  
Vertebral Augmentation ◽  
Lumbosacral Region ◽  
Vas Score

Background: In clinical practice, we have found that the pain caused by thoracolumbar osteoporotic vertebral compression fracture (OVCF) is sometimes not limited to the level of the fractured vertebrae but instead occurs in areas far away from the injured vertebrae, such as the lower back, area surrounding the iliac crest, or buttocks, and this type of pain is known as distant lumbosacral pain. The pathogenesis of pain in distant regions caused by thoracolumbar OVCF remains unclear. Objectives: To compare the clinical efficacy and imaging outcomes of percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) in the treatment of distant lumbosacral pain accompanied by thoracolumbar OVCF and to explore the possible pathogenesis of distant lumbosacral pain caused by thoracolumbar OVCF. Study Design: Retrospective study. Setting: A university hospital spinal surgery departments. Methods: A total of 62 patients who underwent vertebral augmentation for thoracolumbar OVCF with lumbosacral pain were included and divided into the PVP group (28 cases) and the PKP group (34 cases). The Visual Analog Scale (VAS) was used to evaluate the severity of local and distant lumbosacral pain, and the Chinese modified Oswestry Disability Index (CMODI) was used for functional assessment. The anterior vertebral height (AVH) of the fractured vertebrae and local kyphotic angle were measured on plain radiographs. The average follow-up time was 28.62 ± 8.43 months in the PVP group and 29.22 ± 9.09 months in the PKP group. Results: Within the 2 groups, the VAS score of local pain, VAS score of distant lumbosacral pain, and CMODI score at 3 days postoperatively and at the last follow-up improved significantly compared with the scores before surgery. However, there was no significant difference between the 2 groups. At 3 days postoperatively and at last follow-up, the AVH and Cobb angle in the 2 groups improved significantly compared with those before surgery, but the magnitudes of AVH improvement and Cobb angle correction were significantly larger in the PKP group than in the PVP group. Limitations: First, this study is retrospective and may be prone to selection bias. Second, because of cultural and linguistic differences, the original version of the Oswestry Disability Index could not be properly understood and completed by people in mainland China. Therefore in this study, the CMODI was used, but the correlation coefficients of the CMODI within and between groups were 0.953 and 0.912, respectively. Third, a pain diagram was not used to accurately reflect the location of pain in the distant lumbosacral region. Conclusions: Both PVP and PKP can effectively alleviate pain in the distant lumbosacral region caused by thoracolumbar OVCF, and distant lumbosacral pain associated with thoracolumbar OVCF may be considered vertebrogenic referred pain. Key words: Osteoporotic vertebral compression fracture, distant pain, non-midline pain, kyphoplasty, vertebroplasty, vertebral augmentation, lumbosacral pain, Chinese modified Oswestry Disability Index

scholarly journals Long-term outcome of polymethylmethacrylate-augmented screw fixation in the treatment of thoracolumbar spinal tuberculosis in elderly patients with severe osteoporosis

2020 ◽  
Author(s):  
Jun-Song Yang ◽  
Bao-Rong He ◽  
Jian-Min Wei ◽  
Xiang-Fu Wang ◽  
Dongmei Wei ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Cobb Angle ◽  
Bone Grafting ◽  
Screw Fixation ◽  
Spinal Tuberculosis ◽  
Implant Failure ◽  
Severe Osteoporosis ◽  
Posterior Debridement ◽  
Thoracolumbar Spinal Tuberculosis

Abstract Background: to evaluate the safety and efficacy of Polymethylmethacrylate-augmented screw fixation (PASF) in the treatment of elderly patients with thoracolumbar spinal tuberculosis accompanied with severe osteoporosis.Methods: 34 elderly patients with thoracolumbar spinal tuberculosis accompanied with severe osteoporosis underwent PASF after anterior or posterior debridement and bone grafting in our hospital from January 2010 to January 2012. The follow-ups were performed at 1, 3, 6, and 12 months postoperatively and then annually thereafter. The segmental cobb angle was measured to evaluate kyphosis improvement. The laboratory examination including ESR and CRP was also monitored. The pre- and postoperative VAS score, ODI score, and neurological function of ASIA scale were also recorded.Results: The included 21 patients completed the operation successfully. In all patients with neurological dysfunction, the ASIA grade improved by at least 1 grade. One month postoperatively, the VAS score, ODI, segmental Cobb angle, ESR, and CRP were significantly improved compared with those preoperatively (P<0.05); there was no significant difference in the values at 1 month postoperatively and last follow-up (P＞0.05). There were no complications such as implant failure, proximal junctional kyphosis, or recurrence of tuberculosis at the minimum 5-year follow-up. Conclusion: For elderly patients with thoracolumbar spinal tuberculosis complicated with severe osteoporosis, after anterior or posterior debridement and bone grafting, together with postoperative systematic anti-tuberculosis and anti-osteoporosis treatments, PASF is safe and effective without catastrophic complications such as intraspinal cement leakage. During the 5-year follow-up, there was no tuberculosis recurrence or implant failure.

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