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Role of major revision spine surgery in recurrent adjacent segment osteoporotic vertebral body fracture: a case report

  • Orthopaedic Surgery
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Abstract

Study design

Case report.

Clinical question

To report the beneficial effects of kyphoplasty, cement augmentation and extension of posterior instrumentation in a patient with recurrent adjacent segment osteoporotic vertebral body fracture.

Methods

A 72-year-old lady underwent multiple revision spine surgeries for recurrent adjacent segment osteoporotic vertebral body fracture.

Results

The patient underwent four surgeries in 6 years: (1) in 2005, posterior lumbar interbody fusion with stabilization (L4–S1) was done; (2) in August 2010, implants from L4–S1 were removed and revised, transforaminal lumbar interbody fusion was done at L2/L3 and L3/L4 along with pedicle screw stabilization from T12–S1; (3) in September 2011, revision surgery was attempted, wherein a kyphoplasty was done at T12 and the stabilization was extended to T4; (4) again in October 2011, a revision surgery was attempted, wherein a kyphoplasty was done at T5 along with stabilization using pedicular screws in the T2 and T3 vertebrae and lateral mass screws in the C6 vertebra. To current date, the patient is stable with good sagittal and coronal balance and walking pain free without support.

Conclusion

The current case demonstrates the need for posterior spinal reconstruction in osteoporotic vertebral collapse. Cement augmentation and extension of posterior instrumentation are both viable techniques that could be used to improve stabilization in the elderly spine.

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References

  1. Vernon-Roberts B (1992) Malcolm IV Jayson: the lumbar spine and back pain. Churchill Livingstone, Edinburgh, pp 7–41

    Google Scholar 

  2. Fassett DR, Kurd MF, Vaccaro AR (2009) Biologic solutions for degenerative disc disease. J Spinal Disord Tech 22:297–308

    Article  PubMed  Google Scholar 

  3. Grunhagen T, Wilde G, Soukane DM et al (2006) Nutrient supply and intervertebral disc metabolism. J Bone Jt Surg Am 88(Suppl. 2):30–35

    Article  Google Scholar 

  4. Hu SS (1997) Internal fixation in the osteoporotic spine. Spine 22:43–48 (Suppl.)

    Article  Google Scholar 

  5. Wuisman PIJM, Van Dijk M, Staal H, Van Royen BJ (2000) Augmentation of (pedicle) screws with calcium apatite cement in patients with severe progressive osteoporotic spinal deformities: an innovative technique. Eur Spine J 9:528–533

    Article  PubMed  CAS  Google Scholar 

  6. Heini PF (2005) The vurrent treatment—a survey of osteoporotic fracture treatment. Osteoporotic spine fractures: the surgeon’s perspective. Osteoporos Int 16:S85–S92

    Article  PubMed  Google Scholar 

  7. Chang MC, Liu CL, Chen TH (2008) Polymethylmethacrylate augmentation of pedicle screw for osteoporotic spinal surgery: a novel technique. Spine (Phila Pa 1976) 33:E317–E324

    Article  Google Scholar 

  8. Hasegawa K, Hirano T (2002) In: An YH (ed) Internal Fixation in Osteoporotic Bone. Thieme, New York, pp 128–136

    Google Scholar 

  9. Vcelák J, Tóth L, Slégl M, Suman R, Majernícek M (2009) Vertebroplasty and kyphoplasty treatment of osteoporotic vertebral fractures. Acta Chir Orthop Traumatol Cech 76(1):54–59

    PubMed  Google Scholar 

  10. Lieberman IH, Dudeney S, Reinhardt MK, Bell G (2001) Initial outcome and efficacy of “kyphoplasty” in the treatment of painful osteoporotic vertebral compression fractures. Spine (Phila Pa 1976) 26(14):1631–1638

    Article  CAS  Google Scholar 

  11. Chotigavanich C, Sanpakit S, Wantthanaapisith T, Thanapipatsiri S, Chotigavanich C (2009) The surgical treatment of the osteoporotic vertebral compression fracture in the elderly patients with spinal instrumentation. J Med Assoc Thai 92(Suppl 5):S109–S115

    PubMed  Google Scholar 

  12. Korovessis P, Repantis T, Papazisis Z, Iliopoulos P (2010) Effect of sagittal spinal balance, levels of posterior instrumentation, and length of follow-up on low back pain in patients undergoing posterior decompression and instrumented fusion for degenerative lumbar spine disease: a multifactorial analysis. Spine (Phila Pa 1976) 35(8):898–905

    Article  Google Scholar 

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Correspondence to Imtiaz Ghani.

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Ghani, I., Kroeber, M. Role of major revision spine surgery in recurrent adjacent segment osteoporotic vertebral body fracture: a case report. Arch Orthop Trauma Surg 132, 1089–1094 (2012). https://doi.org/10.1007/s00402-012-1518-3

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  • DOI: https://doi.org/10.1007/s00402-012-1518-3

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