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

Abstract

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.