Role of Major Spine Surgery Using Kaneda Anterior Instrumentation for Osteoporotic Vertebral Collapse

Abstract

The current study demonstrated the advantages of anterior spinal reconstruction in osteoporotic vertebral collapse: (1) safe and reliable decompression could be performed, and (2) 80% of patients were successfully treated with anterior spinal reconstruction alone. However, patients with multilevel corpectomies and/or severe osteoporosis highly required posterior reinforcement.

Cement augmented anterior reconstruction with short posterior instrumentation: A less invasive surgical option for Kummell’s disease with cord compression

“…7,26 Table 4 summarizes recent reports of the surgical treatment of Kummell's disease. 7,13,16,27 Operations using various fixation methods and body reconstruction tended to improve the neurological defect. However, complication rates varied from negligible to as high as 70% according to Nguyen et al 27 Compared to results reported for other procedures, vertebroplasty with short-segment fixation did not greatly increase the incidence of adjacent compression fractures or surgical complications.…”

“…However, the average loss of correction during the follow-up period did not differ significantly from that reported for traditional anterior and posterior techniques; the loss of correction ranged from 1°to 5°. 7,8,13,26,27 The occurrence of progressive kyphosis during follow-up is difficult to interpret because progression of an underlying disease, such as osteoporosis, can also lead to further kyphotic deformity.…”

“…7,12 Although anterior thoracolumbar procedures have also been described, in which the diseased body is removed (corpectomy) and an interposition bone graft is placed, they are technically demanding and potentially dangerous in elderly patients or those with osteoporosis. [7][8][9]13 Because many patients have severe osteoporosis or are of advanced age, recent studies have focused on the role of vertebroplasty or kyphoplasty in achieving pain relief and reversing the loss of height and spinal deformity. 4,10,[14][15][16] However, an injection of PMMA into a cystic cavity is believed to have far less interdigitation with the surrounding bone than would an injection into a partially intact trabecular bone.…”

Kümmell's Disease, an Uncommon and Complicated Spinal Disorder: A Review

“…43 There were six complications, but the anterior procedure was found to be generally effective, with a low incidence of instrumentation failure and low morbidity. Kanayama et al 44 found that the mean decrease of kyphotic angle in 31 patients was 10° (after a mean follow-up period of 57 months) with Kaneda anterior spinal instrumentation. Posterior reinforcement was required in six patients who had severe osteoporosis and/or underwent multilevel corpectomies.…”

Posterior-approach Vertebral Replacement With Rectangular Parallelepiped Cages (PAVREC) for the Treatment of Osteoporotic Vertebral Collapse With Neurological Deficits

“…However, because of the medical complications and poor bone quality associated with elderly patients, the optimal procedure remains controversial. 5,6 We began performing posterior-approach vertebral replacement with a cylindrical cage for the treatment of thoracolumbar burst fracture and osteoporotic late vertebral collapse in 2004. 7 The clinical results were satisfactory; however, subsidence of the cage into the vertebrae was seen in several cases.…”