P41. Evaluating the efficacy of vertebroplasty and percutaneous screw fixation in high-risk patients with vertebral fracture non-union and neurological deficit

Abstract

BACKGROUND CONTEXT

Vertebral body fractures with non-union and associated neurological deficits pose significant challenges, especially in high-risk, morbid patients. Traditional surgical interventions may not be feasible due to elevated perioperative risks.

PURPOSE

This prospective study evaluates safety, efficacy, and outcomes of vertebroplasty combined with percutaneous screw fixation in treating vertebral body fracture non-unions with neurological deficits in high-risk patients.

STUDY DESIGN/SETTING

This is a prospective, single-center study conducted to evaluate the clinical and radiological outcomes of vertebroplasty combined with O-arm-guided, navigation-assisted percutaneous screw fixation for the treatment of vertebral body fracture non-unions with neurological deficits in high-risk, morbid patients.

PATIENT SAMPLE

A total of 32 high-risk patients with vertebral body fracture non-unions and associated neurological deficits were included in this study.

OUTCOME MEASURES

Pain Relief: Assessed using the Visual Analog Scale (VAS) preoperatively and at 1, 3, 6 months, and 2–4 years postoperatively. Neurological Recovery: Evaluated through improvements in motor and sensory function based on clinical examination. Functional Improvement: Measured using the Oswestry Disability Index (ODI) at the same time points as VAS assessments. Fracture Stability: Confirmed through radiological imaging (X-ray/CT scans) to verify proper screw placement and fusion. Complications: Documented intraoperative and postoperative adverse events, including infection, screw malposition, or procedure-related morbidity.

METHODS

This prospective study included high-risk patients with vertebral body fracture non-unions and associated neurological deficits. Patients were classified as high surgical risk based on comorbid conditions and perioperative risk factors. All patients underwent vertebroplasty and O-arm-guided, navigation-assisted percutaneous screw fixation. Vertebroplasty was performed to provide immediate pain relief and augment the structural integrity of the fractured vertebral body. Percutaneous screws were placed under real-time navigation to stabilize the fracture and prevent further displacement. Data collection included: Operative Parameters: operative time and intraoperative blood loss. Clinical Outcomes: pain relief assessed via the Visual Analog Scale (VAS), neurological recovery via clinical examination, and functional improvement using the Oswestry Disability Index (ODI). Radiological Outcomes: stability and accuracy of screw placement confirmed through postoperative imaging. Follow-up assessments were conducted at 1, 3, and 6 months postoperatively, and then annually for 2–4 years. Statistical analyses were performed to compare preoperative and postoperative outcomes, with significance defined as p <0.05.

RESULTS

Significant improvement in pain and functional outcomes was observed postoperatively. Neurological deficits improved in a significant number of patients. Complication rates were minimal, with no major adverse events reported. Radiological imaging confirmed fracture stability and proper screw placement in all cases.

CONCLUSIONS

Vertebroplasty with percutaneous screw fixation is a viable and minimally invasive treatment option for vertebral body fracture non-union with neuro-deficits in high-risk, morbid patients. The procedure offers pain relief, functional improvement, and fracture stabilization with low complication rates.

FDA Device/Drug Status

This abstract does not discuss or include any applicable devices or drugs.