Late collapse osteoporotic vertebral fracture in an elderly patient with neurological compromise

D. Ruiz Picazo, J. Ramírez Villaescusa, E. Portero Martínez, F. Doñate Pérez

November 2014, Volume 23, Issue 12, pp 2696 - 2702 Grand Rounds Read Full Article

First Online: 19 June 2013

[InlineMediaObject not available: see fulltext.] Vertebral fracture is a frequent phenomenon in people with osteoporosis and does not lead to clinical problems in most cases. Only a small number of patients suffer from serious neurological complications related to late collapse. Acute or subacute painful osteoporotic vertebral fracture can be tackled using reinforcement techniques; however, neural compression by displaced bone fragments and late kyphosis can produce neurological deficit and require surgical decompression and stabilization. The identification of risk factors associated with a patient’s poor recovery is important for adequate treatment. In elderly patients, both the morbidity of the approach and the difficulty of stabilization are the main drawbacks. We present here a case study of an osteoporotic fracture in an elderly man with severe late collapse and neurological impairment. A posterior approach was used with bilateral posterior transpedicular decompression and instrumented arthrodesis with cemented pedicle screws. The post-operative period was incident-free and the patient recovered the neurological deficit and the ability to walk.

Read Full Article