{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:06:13Z","timestamp":1792789573616,"version":"4.5.0"},"reference-count":24,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:00:00Z","timestamp":1773878400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Complicated osteoporotic thoracolumbar fractures represent a major surgical challenge because compromised bone quality predisposes to progressive deformity, neurological deterioration, and fixation failure. This study aimed to evaluate the clinical and radiological outcomes of hybrid stabilization in patients with severe osteoporotic fractures classified as AO Spine-DGOU OF4\u2013OF5. Materials and Methods: This single-center retrospective observational cohort study included 87 consecutively treated patients with complicated osteoporotic thoracolumbar fractures who underwent surgical treatment between 2012 and 2022. Clinical outcomes were assessed using the Visual Analog Scale (VAS) and Oswestry Disability Index (ODI). Radiological outcomes included the regional kyphotic angle (RKA) and interbody fusion graded according to the Bridwell classification. Imaging was reviewed preoperatively, immediately postoperatively, and at follow-up, with 12-month outcomes used for the principal analysis. Additionally, a retrospective comparative analysis was undertaken between the two largest fixation subgroups within the cohort to explore outcome differences across the most representative construct patterns. Results: At 12 months, complete interbody fusion (Bridwell grade I) was achieved in 75.9% of patients. Mean RKA improved from 29.4\u00b0 \u00b1 14.1\u00b0 preoperatively to 7.9\u00b0 \u00b1 8.0\u00b0 immediately after surgery, with only minimal loss of correction during follow-up. Mean VAS improved from 7.0 \u00b1 1.8 to 2.1 \u00b1 1.2, while mean ODI decreased from 61.3% \u00b1 6.8% to 9.8% \u00b1 1.2% (both p &lt; 0.001). Reoperation for implant-related mechanical failure was required in three patients (3.4%). Conclusions: Hybrid stabilization with cement augmentation was associated with marked improvement in pain, functional disability, and sagittal alignment, as well as a high rate of interbody fusion at 12 months, in patients with complicated osteoporotic thoracolumbar fractures. Given the retrospective observational design, these findings should be interpreted as associations within the treated cohort. Prospective comparative studies are warranted to further validate these results.<\/jats:p>","DOI":"10.3390\/medicina62030573","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T08:54:37Z","timestamp":1773910477000},"page":"573","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Outcomes of Hybrid Cement-Augmented Pedicle Screw Fixation in Complicated Osteoporotic Thoracolumbar Fractures: A Single-Centre Experience"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-4421-3313","authenticated-orcid":false,"given":"Nurzhan","family":"Abishev","sequence":"first","affiliation":[{"name":"Department of Spinal Neurosurgery and Peripheral Nervous System Pathology, National Center for Neurosurgery, Astana 010000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0862-1747","authenticated-orcid":false,"given":"Talgat","family":"Kerimbayev","sequence":"additional","affiliation":[{"name":"Department of Spinal Neurosurgery and Peripheral Nervous System Pathology, National Center for Neurosurgery, Astana 010000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-3045-0276","authenticated-orcid":false,"given":"Daryn","family":"Borangaliyev","sequence":"additional","affiliation":[{"name":"Department of Spinal Neurosurgery and Peripheral Nervous System Pathology, National Center for Neurosurgery, Astana 010000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3052-345X","authenticated-orcid":false,"given":"Galymzhan","family":"Kadirbekov","sequence":"additional","affiliation":[{"name":"Department of Spinal Neurosurgery and Peripheral Nervous System Pathology, National Center for Neurosurgery, Astana 010000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4130-0486","authenticated-orcid":false,"given":"Zhandos","family":"Tuigynov","sequence":"additional","affiliation":[{"name":"Department of Spinal Neurosurgery and Peripheral Nervous System Pathology, National Center for Neurosurgery, Astana 010000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8276-4584","authenticated-orcid":false,"given":"Yermek","family":"Urunbayev","sequence":"additional","affiliation":[{"name":"Department of Spinal Neurosurgery and Peripheral Nervous System Pathology, National Center for Neurosurgery, Astana 010000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3600-0115","authenticated-orcid":false,"given":"Meirzhan","family":"Oshayev","sequence":"additional","affiliation":[{"name":"Department of Spinal Neurosurgery and Peripheral Nervous System Pathology, National Center for Neurosurgery, Astana 010000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viktor","family":"Aleinikov","sequence":"additional","affiliation":[{"name":"Department of Spinal Neurosurgery and Peripheral Nervous System Pathology, National Center for Neurosurgery, Astana 010000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2457-7184","authenticated-orcid":false,"given":"Yergen","family":"Kenzhegulov","sequence":"additional","affiliation":[{"name":"Department of Spinal Neurosurgery and Peripheral Nervous System Pathology, National Center for Neurosurgery, Astana 010000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5119-6443","authenticated-orcid":false,"given":"Medet","family":"Toleubayev","sequence":"additional","affiliation":[{"name":"Department of Surgery, Astana Medical University, Astana 010000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7251-0881","authenticated-orcid":false,"given":"Mariya","family":"Dmitriyeva","sequence":"additional","affiliation":[{"name":"Department of Surgery, Astana Medical University, Astana 010000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7257-4810","authenticated-orcid":false,"given":"Makar","family":"Solodovnikov","sequence":"additional","affiliation":[{"name":"Department of Spinal Neurosurgery and Peripheral Nervous System Pathology, National Center for Neurosurgery, Astana 010000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serik","family":"Akshulakov","sequence":"additional","affiliation":[{"name":"Department of Spinal Neurosurgery and Peripheral Nervous System Pathology, National Center for Neurosurgery, Astana 010000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Zhang, Y., Lu, Y., Lin, W., Yao, M., Song, J., and Ding, L. (2024). Surgical management of lower limb radiculopathy following acute single-level osteoporotic vertebral fracture of lower lumbar spine in geriatric patient: A retrospective study. BMC Musculoskelet. Disord., 25.","DOI":"10.1186\/s12891-024-07314-3"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1007\/s00068-016-0751-9","article-title":"Osteoporotic vertebral body fractures of the thoracolumbar spine: Indications and techniques of a 360\u00b0-stabilization","volume":"43","author":"Spiegl","year":"2017","journal-title":"Eur. J. Trauma Emerg. Surg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"46S","DOI":"10.1177\/2192568217717972","article-title":"Classification of Osteoporotic Thoracolumbar Spine Fractures: Recommendations of the Spine Section of the German Society for Orthopaedics and Trauma (DGOU)","volume":"8","author":"Schnake","year":"2018","journal-title":"Glob. Spine J."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Xu, Z., Hao, D., Dong, L., Yan, L., and He, B. (2021). Surgical options for symptomatic old osteoporotic vertebral compression fractures: A retrospective study of 238 cases. BMC Surg., 21.","DOI":"10.1186\/s12893-020-01013-1"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1519","DOI":"10.1016\/j.spinee.2015.02.038","article-title":"The comparison of pedicle screw and cortical screw in posterior lumbar interbody fusion: A prospective randomized noninferiority trial","volume":"15","author":"Lee","year":"2015","journal-title":"Spine J."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"102779","DOI":"10.1016\/j.otsr.2020.102779","article-title":"Treatment of osteoporotic vertebral fractures","volume":"107","author":"Prost","year":"2021","journal-title":"Orthop. Traumatol. Surg. Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/j.jss.2010.09.009","article-title":"Surgical Treatment of Osteoporotic Thoracolumbar Compressive Fractures with Open Vertebral Cement Augmentation of Expandable Pedicle Screw Fixation: A Biomechanical Study and a 2-Year Follow-up of 20 Patients","volume":"173","author":"Wu","year":"2012","journal-title":"J. Surg. Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1177\/230949901001800204","article-title":"Mortality after Vertebral Fractures in a Japanese Population","volume":"18","author":"Ikeda","year":"2010","journal-title":"J. Orthop. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1020","DOI":"10.1016\/j.jos.2019.07.018","article-title":"Surgical outcomes of spinal fusion for osteoporotic vertebral fracture in the thoracolumbar spine: Comprehensive evaluations of 5 typical surgical fusion techniques","volume":"24","author":"Watanabe","year":"2019","journal-title":"J. Orthop. Sci."},{"key":"ref_10","unstructured":"Doyle, D.J., Hendrix, J.M., and Garmon, E.H. (2025, January 09). American Society of Anesthesiologists Classification, StatPearls [Internet], Available online: http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK441940\/."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"E120","DOI":"10.1097\/BRS.0000000000000661","article-title":"Comparative Study of 2 Surgical Procedures for Osteoporotic Delayed Vertebral Collapse: Anterior and Posterior Combined Surgery Versus Posterior Spinal Fusion with Vertebroplasty","volume":"40","author":"Nakashima","year":"2015","journal-title":"Spine"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1384","DOI":"10.1359\/jbmr.2000.15.7.1384","article-title":"Health-Related Quality of Life in Postmenopausal Women with Low BMD with or Without Prevalent Vertebral Fractures","volume":"15","author":"Oleksik","year":"2000","journal-title":"J. Bone Miner. Res."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1097\/BSD.0b013e318193e3a5","article-title":"Role of Major Spine Surgery Using Kaneda Anterior Instrumentation for Osteoporotic Vertebral Collapse","volume":"23","author":"Kanayama","year":"2010","journal-title":"J. Spinal Disord. Tech."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1097\/01.bsd.0000097253.54459.a6","article-title":"Vertebral Reconstruction with Biodegradable Calcium Phosphate Cement in the Treatment of Osteoporotic Vertebral Compression Fracture Using Instrumentation","volume":"17","author":"Matsuyama","year":"2004","journal-title":"J. Spinal Disord. Tech."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1007\/s00586-008-0821-8","article-title":"Posterior instrumented fusion without neural decompression for incomplete neurological deficits following vertebral collapse in the osteoporotic thoracolumbar spine","volume":"18","author":"Ataka","year":"2009","journal-title":"Eur. Spine J."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1038\/sj.sc.3102052","article-title":"Posterior spinal shortening for paraparesis following vertebral collapse due to osteoporosis","volume":"46","author":"Saita","year":"2008","journal-title":"Spinal Cord."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.2106\/JBJS.J.00160","article-title":"Hounsfield Units for Assessing Bone Mineral Density and Strength: A Tool for Osteoporosis Management","volume":"93","author":"Schreiber","year":"2011","journal-title":"J. Bone Jt. Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"232","DOI":"10.21037\/jss-23-121","article-title":"Side specific differences of Hounsfield-Units in the osteoporotic lumbar spine","volume":"10","author":"Metzner","year":"2024","journal-title":"J. Spine Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1007\/s11657-018-0512-y","article-title":"Global sagittal alignment in elderly patients with osteoporosis and its relationship with severity of vertebral fracture and quality of life","volume":"13","author":"Hu","year":"2018","journal-title":"Arch. Osteoporos."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Chen, S.-W., Wu, W.-T., Lee, R.-P., Yu, T.-C., Chen, I.-H., Wang, J.-H., and Yeh, K.-T. (2024). Correlations between Sagittal Parameters and Functional Scores in 65-Year-Old Osteoporotic Females with Vertebral Body Fracture Under Low-Energy Mechanism. J. Clin. Med., 13.","DOI":"10.3390\/jcm13030774"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e1079","DOI":"10.1016\/j.wneu.2018.05.171","article-title":"Long-Segment or Bone Cement\u2013Augmented Short-Segment Fixation for Kummell Disease with Neurologic Deficits? A Comparative Cohort Study","volume":"116","author":"Huang","year":"2018","journal-title":"World Neurosurg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"424","DOI":"10.31616\/asj.2020.0033","article-title":"Long versus Short Segment Instrumentation in Osteoporotic Thoracolumbar Vertebral Fracture","volume":"15","author":"Girardo","year":"2021","journal-title":"Asian Spine J."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Lai, O., Zhang, X., Hu, Y., Sun, X., Zhu, B., Dong, W., and Yuan, Z. (2022). Long-segment fixation VS short-segment fixation combined with kyphoplasty for osteoporotic thoracolumbar burst fracture. BMC Musculoskelet. Disord., 23.","DOI":"10.1186\/s12891-022-05109-y"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1186\/s41205-025-00294-7","article-title":"Biomechanical and clinical evaluation of 3D-printed personalized vertebral implants after total En-Bloc spondylectomy: Two-year follow-up outcomes","volume":"11","author":"Aleinikov","year":"2025","journal-title":"3D Print. Med."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/3\/573\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T09:49:16Z","timestamp":1773913756000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/3\/573"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,19]]},"references-count":24,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["medicina62030573"],"URL":"https:\/\/doi.org\/10.3390\/medicina62030573","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,19]]}}}