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Cluster phenomenon of vertebral refractures after posterior pedicle screw fixation in a patient with glucocorticosteroid-induced Kümmell’s disease: a treatment dilemma

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Abstract

Introduction

Surgical treatments are usually preferred in patients with Kümmell’s disease since it represents a failure of conservative treatment for osteoporotic vertebral compression fracture without evidence of spontaneous healing. However, the risk of postoperative refractures is much higher in patients with glucocorticosteroid-induced osteoporosis (GIOP) than in those with primary osteoporosis, possessing a therapeutic challenge and dilemma to orthopaedic surgeons.

Case report

We described a rare cluster phenomenon of vertebral refractures in a patient with GIOP subsequent to segmental internal fixation for the initial management of glucocorticosteroid-induced Kümmell’s disease, and a review of the literature.

Conclusion

Our patient illustrates that clinicians should be aware of the significant management dilemma and possible disastrous outcome after surgical interventions for glucocorticosteroid-induced Kümmell’s disease and, thus, pay much more attention to comprehensive perioperative antiosteoporotic medications for patients with GIOP in current medical treatment.

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Correspondence to Chao Zhang.

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The study was approved by the Ethics Committee of Chinese PLA General Hospital, and informed consent was obtained from the patient to publish the details of her case.

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Written informed consent was obtained from the patient.

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Zhang, C., Wen, T., Li, C. et al. Cluster phenomenon of vertebral refractures after posterior pedicle screw fixation in a patient with glucocorticosteroid-induced Kümmell’s disease: a treatment dilemma. Arch Osteoporos 16, 93 (2021). https://doi.org/10.1007/s11657-021-00941-6

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  • DOI: https://doi.org/10.1007/s11657-021-00941-6

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