Abstract
Introduction
Spinal shortening is indicated for osteoporotic vertebral collapse. However, this surgical procedure has not been indicated for more than two vertebral levels that are not adjacent. We experienced a rare case of paraparesis due to osteoporotic vertebral collapse of two vertebral bodies with a normal vertebra in between and treated successfully by the double-level posterior shortening procedure.
Materials and methods
A 79-year-old woman suffered from delayed paraparesis 2 years after L1 and Th11 vertebral body compression fracture. Plain X-ray photographs showed Th11 and L1 vertebral body collapse, Th7 compression fracture and a kyphosis angle of 30° from Th10 to L2. Plain magnetic resonance imaging showed spinal canal stenosis at Th11 and L1 vertebral body levels. She was treated by double-level posterior spinal shortening using pedicle screw and hook systems.
Results
After the procedure, the patient’s kyphosis angle decreased to 10° and her back pain, leg pain, and sensory deficits improved. She was able to walk by herself. Although new vertebral compression fractures occurred at L4 and L5 in the follow-up period, there has been no deterioration of the neurological symptoms 5 years after the operation.
Conclusion
Delayed paraparesis after double-level thoracolumbar vertebral collapse due to osteoporosis was treated successfully by double-level posterior spinal shortening using a pedicle screw and hook system.
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References
Arciero RA, Leung KY, Pierce JH (1989) Spontaneous unstable burst fracture of the thoracolumbar spine in osteoporosis. A report of two cases. Spine 14:114–117
Gertzbein SD, Harris MB (1992) Wedge osteotomy for the correction of post-traumatic kyphosis. A new technique and a report of three cases. Spine 17:374–379
Halvorson TL, Kelley LA, Thomas KA, Whitecloud TS 3rd, Cook SD (1994) Effects of bone mineral density on pedicle screw fixation. Spine 19:2415–2420
Hasegawa K, Takahashi HE, Uchiyama S, Hirano T, Hara T, Washio T, Sugiura T, Youkaichiya M, Ikeda M (1997) An experimental study of a combination method using a pedicle screw and laminar hook for the osteoporotic spine. Spine 22:958–962
Heining CF (1984) Eggshell procedure. In: Luque ER (ed) Segmental spinal instrumentation. Slack, Thorofare, pp 221–234
Kaneda K, Asano S, Hashimoto T, Satoh S, Fujiya M (1992) The treatment of osteoporotic-posttraumatic vertebral collapse using the Kaneda device and a bioactive ceramic vertebral prosthesis. Spine 17:S295–S303
Kempinsky WH, Morgan PP, Boniface WR (1958) Osteoporotic kyphosis with paraplegia. Neurology 8:181–186
Kim KT, Suk KS, Kim JM, Lee SH (2003) Delayed vertebral collapse with neurological deficits secondary to osteoporosis. Int Orthop 27:65–69
Kostuik JP, Matsusaki H (1989) Anterior stabilization, instrumentation, and decompression for post-traumatic kyphosis. Spine 14:379–386
Lee YL, Yip KM (1996) The osteoporotic spine. Clin Orthop Relat Res 323:91–97
Maruo S, Tatekawa F, Nakano K (1987) Paraplegia caused by vertebral compression fractures in senile osteoporosis. Z Orthop Ihre Grenzgeb 125:320–323
Murakami H, Yamazaki K, Attallah-Wasif ES, Tsai KJ, Shimamura T, Hutton WC (2006) A biomechanical study of 3 different types of sublaminar wire used for constructs in the thoracic spine. J Spinal Disord Tech 19:442–446
Saita K, Hoshino Y, Kikkawa I, Nakamura H (2000) Posterior spinal shortening for paraplegia after vertebral collapse caused by osteoporosis. Spine 25:2832–2835
Salomon C, Chopin D, Benoist M (1988) Spinal cord compression: an exceptional complication of spinal osteoporosis. Spine 13:222–224
Shikata J, Yamamuro T, Iida H, Shimizu K, Yoshikawa J (1990) Surgical treatment for paraplegia resulting from vertebral fractures in senile osteoporosis. Spine 15:485–489
Shimizu K, Ido K, Fujio K, Tanaka K, Nakamura T (1996) Total spondylectomy and spinal shortening for giant-cell tumour of spine. Lancet 348:342
Shimizu K, Hosoe H, Sakaguchi Y, Nishimoto H, Miyamoto K (2000) Spinal shortening for osteoporotic vertebral collapse. In: Proceedings of British orthopaedic association Japanese orthopaedic association combined congress, UK
Suk SI, Kim JH, Lee SM, Chung ER, Lee JH (2003) Anterior-posterior surgery versus posterior closing wedge osteotomy in posttraumatic kyphosis with neurologic compromised osteoporotic fracture. Spine 28:2170–2175
Toyone T, Tanaka T, Wada Y, Kamikawa K, Ito M, Kimura K, Yamashita T, Matsushita S, Shiboi R, Kato D, Kaneyama R (2006) Vertebral compression fractures following lumbar and thoracolumbar spinal instrumentation surgery: a study with a five-year minimum follow-up. International Society for the Study of the Lumbar Spine, Bergen
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Kikuike, K., Miyamoto, K., Hosoe, H. et al. Double-level posterior spinal shortening for paralytic osteoporotic vertebral collapse of two vertebral bodies with a normal vertebra in between: a case report. Arch Orthop Trauma Surg 129, 57–60 (2009). https://doi.org/10.1007/s00402-008-0606-x
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DOI: https://doi.org/10.1007/s00402-008-0606-x