[SRS-Schwab grade

Objective: To evaluate the effectiveness of SRS-Schwab grade Ⅳ osteotomy combined with satellite rod for thoracolumbar old osteoporotic fracture with severe kyphosis. Methods: Between April 2013 and August 2016, 20 cases of thoracolumbar old osteoporotic fracture with severe kyphosis were treated with SRS-Schwab grade Ⅳ osteotomy combined with satellite rod. All the patients were females, aged 49-71 years (mean, 54.8 years). The disease duration was 6-28 months with an average of 14 months. The T value of bone density was -4.4 to -1.8 (mean, -2.8). The preoperative Cobb angle was (43.0±11.3)°. The vertebral compression fracture segment was T Results: The operation time was 180-314 minutes (mean, 226 minutes). The intraoperative blood loss was 390-1 800 mL (mean, 750 mL). All the incisions healed by first intension without incision infection. Twenty patients were followed up 24-52 months, with an average of 30.9 months. During the follow-up period, no significant complication such as correction loss, nail breakage, rod breakage, pseudoarthrosis formation, or proximal and distal junctional kyphosis occurred. All patients were able to walk upright after operation, and the pain relieved significantly at 6 months after operation. Bone fusion achieved at 12 months after operation. The Frankel grade of nerve function improved from grade D to grade E at last follow-up in 5 patients with nerve damage before operation. At last follow-up, the indicator scores of ODI significantly improved when compared with preoperative values ( Conclusion: SRS-Schwab grade Ⅳ osteotomy combined with satellite rod for thoracolumbar old osteoporotic fracture with severe kyphosis is effective in achieving satisfactory clinical outcomes, as well as maintaining correction of kyphosis.