scholarly journals Intravertebral cleft in pathological vertebral fracture resulting from spinal tuberculosis: a case report and literature review

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Liang Dong ◽  
Chunke Dong ◽  
Yuting Zhu ◽  
Hongyu Wei
Keyword(s):  
Back Pain ◽  
Vertebral Fracture ◽  
Benign Lesion ◽  
Spinal Tuberculosis ◽  
Compression Fracture ◽  
Lower Limbs ◽  
Vertebral Compression Fractures ◽  
Minor Trauma ◽  
Ct Guided ◽  
Intravertebral Cleft

Abstract Background Among common findings in osteoporotic vertebral compression fractures (OVCFs), the intravertebral cleft (IVC) is usually considered a benign lesion. The current study was aimed to present a rare case of vertebral fracture caused by IVC-related spinal tuberculosis. Case presentation A 73-year-old female complained of back pain and weakness in lower limbs for 2 weeks. 3 months ago, after a minor trauma, she got back pain without weakness in lower limbs. Initially, she was diagnosed with a L1 compression fracture and accepted conservative treatment. After an asymptomatic period, she complained progressive pain at the fracture position with weakness of both lower limbs and was referred to our hospital with suspicion of Kümmell’s disease. The patient underwent posterior debridement and internal fixation for decompression and stabilization of the spine. Pathological examinations revealed the patient with spinal tuberculosis. Conclusions Although IVC is common in patients with OCVFs, there are some cases believed to be found in patients with spinal tuberculosis or infection. Further test, like CT-guided puncture biopsy, may be required before decisive treatment when an IVC is observed.

scholarly journals Prospective Single-Site Experience with Radiofrequency-Targeted Vertebral Augmentation for Osteoporotic Vertebral Compression Fracture

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Franklin G. Moser ◽  
Marcel M. Maya ◽  
Laura Blaszkiewicz ◽  
Andrea Scicli ◽  
Larry E. Miller ◽  
...  
Keyword(s):  
Back Pain ◽  
Vertebral Compression Fracture ◽  
Compression Fracture ◽  
Pain Medication ◽  
Pain Severity ◽  
Vertebral Compression Fractures ◽  
Height Loss ◽  
Vertebral Augmentation ◽  
Adjacent Vertebral Body ◽  
Back Function

Vertebral augmentation procedures are widely used to treat osteoporotic vertebral compression fractures (VCFs). We report our initial experience with radiofrequency-targeted vertebral augmentation (RF-TVA) in 20 patients aged 50 to 90 years with single-level, symptomatic osteoporotic VCF between T10 and L5, back pain severity > 4 on a 0 to 10 scale, Oswestry Disability Index ≥ 21%, 20% to 90% vertebral height loss compared to adjacent vertebral body, and fracture age < 6 months. After treatment, patients were followed through hospital discharge and returned for visits after 1 week, 1 month, and 3 months. Back pain severity improved 66% (P<0.001), from 7.9 (95% CI: 7.1 to 8.6) at pretreatment to 2.7 (95% CI: 1.5 to 4.0) at 3 months. Back function improved 46% (P<0.001), from 74 (95% CI: 69% to 79%) at pretreatment to 40 (95% CI: 33% to 47%) at 3 months. The percentage of patients regularly consuming pain medication was 70% at pretreatment and only 21% at 3 months. No adverse events related to the device or procedure were reported. RF-TVA reduces back pain severity, improves back function, and reduces pain medication requirements with no observed complications in patients with osteoporotic VCF.

Development and psychometric properties of the Vertebral Compression Fracture Pain and Functional Disability Questionnaire

2006 ◽  
Vol 5 (3) ◽  
pp. 217-223 ◽  
Author(s):  
Avery J. Evans ◽  
Kevin E. Kip ◽  
Selene M. Boutin
Keyword(s):  
Back Pain ◽  
Vertebral Compression Fracture ◽  
Functional Disability ◽  
Compression Fracture ◽  
Internal Consistency Reliability ◽  
Vertebral Compression Fractures ◽  
Baseline Questionnaire ◽  
Before And After ◽  
Disability Questionnaire ◽  
Criterion Referenced

Object Vertebral compression fractures (VCFs) result in severe and disabling pain, diminished quality of life, and substantial medical costs. There exists no standard instrument with which to measure pain and functional status before and after treatment of VCFs. Methods A questionnaire was specifically developed to assess pain and disability in patients with VCFs before and after undergoing percutaneous polymethylmethacrylate–augmented vertebroplasty. The first section of the baseline questionnaire (before treatment) contains 11 items that address the patient’s previous and current levels of back pain and distress. The second section of the baseline questionnaire lists 24 activities of daily living (ADLs), each measured on a four-point scale ranging from “able to do without pain” to “cannot do because of pain.” The follow-up questionnaire (after treatment) is similar in format. Among 72 vertebroplasty-treated patients, the internal consistency reliability of the 24 ADLs ranged from 0.87 to 0.98, with similar results observed before and after treatment. Correlations of 0.29 to 0.72 were observed among the 24 ADLs and the internal measures of pain and distress measured on both visual analog and adjectival scales. Similar correlations (range 0.35–0.63) were observed between the questionnaire and 10 dimensions of the Oswestry Disability Index’s low-back pain questionnaire, an external instrument used to assess criterion-referenced validity. Evidence in support of the validity of the questionnaire was present before and after treatment. Conclusions The Vertebral Compression Fracture Pain and Functional Disability Questionnaire appears to be a reliable and valid instrument for assessing back pain and functional ability in patients before and after treatment for VCFs.

scholarly journals Spontaneous Spine Fracture in Patient with Ankylosing Spondylitis under Spinal Anesthesia: A Case Report and Review of the Literature

Medicina ◽  
2021 ◽  
Vol 57 (10) ◽  
pp. 1051
Author(s):  
Ul-Oh Jeung ◽  
Dae-Chang Joo ◽  
Sung-Kyu Kim ◽  
Chae-Jin Im
Keyword(s):  
Back Pain ◽  
Ankylosing Spondylitis ◽  
Vertebral Fracture ◽  
Spinal Anesthesia ◽  
Minor Trauma ◽  
Poor Bone Quality ◽  
Structural Weakness ◽  
Extension Force ◽  
History Of ◽  
Magnetic Resonance Imaging Mri

Factures in ankylosing spondylitis (AS) patients tend to occur due to the absence of motion between vertebrae, poor bone quality, and a long lever arm that generates extension force. However, most patients have a history of at least minor trauma. The aim of this report was that a vertebral fracture in a patient with AS can be caused not only by minor trauma, but also by position changes or maintenance of position for examination due to structural weakness. A 75-year-old woman with AS visited her local hospital on foot for back pain. She usually had back pain. However, she had increased back pain after falling over three weeks prior. In plain radiographs, no fracture was apparent. The doctor tried to perform magnetic resonance imaging (MRI) for further evaluation. However, several attempts of MRI failed due to continuous movement arising from pain. As a result, MRI was performed under spinal anesthesia for pain control. However, complete paraplegia developed during the MRI examination. MRI showed extension-type vertebral fracture with displacement and the patient was transferred to our hospital. We performed emergency posterior fusion, but neurological symptoms did not improve. This case suggests the need for careful positioning, sedation, or anesthesia when performing an examination or surgery in AS patients. We recommend that all patients with AS should be carefully positioned at all times during testing or surgery.

A Retrospective Analysis in 1347 Patients Undergoing Cement Augmentation for Osteoporotic Vertebral Compression Fracture: Is the Sandwich Vertebra at a Higher Risk of Further Fracture?

Neurosurgery ◽  
2020 ◽  
Author(s):  
Ping-Yeh Chiu ◽  
Fu-Cheng Kao ◽  
Ming-Kai Hsieh ◽  
Tsung-Ting Tsai ◽  
Wen-Jer Chen ◽  
...  
Keyword(s):  
Vertebral Fracture ◽  
Medical Center ◽  
Demographic Data ◽  
Compression Fracture ◽  
Cement Augmentation ◽  
Vertebral Compression Fractures ◽  
Imaging Findings ◽  
Patient Reported ◽  
Potential Risk Factors ◽  
Adjacent Fractures

Abstract BACKGROUND Multiple percutaneous vertebral cement augmentation may create sandwich vertebrae. Whether the sandwich vertebra is at higher risk of further fracture remains unknown. OBJECTIVE To compare the incidence of further fractures of sandwich vertebrae and adjacent vertebrae and to identify potential risk factors for sandwich vertebral fractures. METHODS Patients who underwent cement augmentation for osteoporotic vertebral compression fractures (OVCFs) in a single medical center between January 2012 and December 2015 were included. A sandwich vertebra was defined as an intact vertebra located between 2 previously cemented vertebrae. Demographic data and imaging findings were recorded. All patients were followed up for at least 24 mo postoperatively. During follow-up period, if the patient reported new-onset back pain with corresponding imaging findings, a diagnosis of sandwich vertebral fracture was made. RESULTS Among the 1347 patients who underwent vertebroplasty/kyphoplasty for OVCFs, 127 patients with 128 fracture levels met the criteria for sandwich vertebrae (females/males 100/27, mean age 77.8 ± 7.7 yr old). The fracture location was most common in the thoraco-lumbar junction (T10-L2), 68.5% (87/127). The incidence of sandwich vertebral fracture was 21.3%, whereas the incidence of adjacent level fracture of those with no sandwich vertebra was 16.4% (196/1194), P = .1879. CONCLUSION The incidence of sandwich vertebral fracture is not higher than that at the adjacent levels. The factor associated with further sandwich vertebral fracture was male gender. Once sandwich vertebral fracture occurred, patients may seek more surgical intervention than those with only adjacent fractures.

scholarly journals Comparison of Rigid and Soft-Brace Treatments for Acute Osteoporotic Vertebral Compression Fracture: A Prospective, Randomized, Multicenter Study

2019 ◽  
Vol 8 (2) ◽  
pp. 198 ◽  
Author(s):  
Tsuyoshi Kato ◽  
Hiroyuki Inose ◽  
Shoichi Ichimura ◽  
Yasuaki Tokuhashi ◽  
Hiroaki Nakamura ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Back Pain ◽  
Outcome Measures ◽  
Vertebral Body ◽  
Compression Fracture ◽  
Secondary Outcome ◽  
Vertebral Compression Fractures ◽  
Brace Treatment ◽  
Compression Fractures

While bracing is the standard conservative treatment for acute osteoporotic compression fracture, the efficacy of different brace treatments has not been extensively studied. We aimed to clarify and compare the preventive effect of the different brace treatments on the deformity of the vertebral body and other clinical results in this patient cohort. This multicenter nationwide prospective randomized study included female patients aged 65–85 years with acute one-level osteoporotic compression fractures. We assigned patients within four weeks of injury to either a rigid-brace treatment or a soft-brace treatment. The main outcome measure was the anterior vertebral body compression percentage at 48 weeks. Secondary outcome measures included scores on the European Quality of Life-5 Dimensions (EQ-5D), visual analog scale (VAS) for lower back pain, and the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ). A total of 141 patients were assigned to the rigid-brace group, whereas 143 patients were assigned to the soft-brace group. There were no statistically significant differences in the primary outcome and secondary outcome measures between groups. In conclusion, among patients with fresh vertebral compression fractures, the 12-week rigid-brace treatment did not result in a statistically greater prevention of spinal deformity, better quality of life, or lesser back pain than soft-brace.

scholarly journals A Study on Vertebral Compression Fracture in Postmenopausal Women with Back Pain in Two Medical College Hospitals of Bangladesh

2020 ◽  
Vol 18 (2) ◽  
pp. 49-53
Author(s):  
Khairul Anam ◽  
Sumia Ahmed Tazri ◽  
Fairzu Faiza ◽  
AKM Maruf Raza
Keyword(s):  
Back Pain ◽  
Rural Communities ◽  
Postmenopausal Women ◽  
Social Life ◽  
Vertebral Compression Fracture ◽  
Compression Fracture ◽  
Cross Sectional Study ◽  
Vertebral Compression Fractures ◽  
Cross Sectional ◽  
Medical College

Background: To determine the prevalence and nature of the vertebral compression fracture in postmenopausal women suffering from back pain in the rural communities of Bangladesh. Materials and methods: Cross sectional study was conducted for the period January to December 2018 which included all postmenopausal women aged 55 years and above presented with back pain in the Obstetrics and Gynaecology and Orthopedic outpatient Departments of Jahurul Islam Medical College and North Bengal Medical College Hospitals. Vertebral fractures were diagnosed by X-Ray scanning of the spine based on predefined criteria. Results: Prevalence of vertebral compression fracture was 30.6%. Most of the subjects were highly active, of poor nutritional status and undergraduate. Majority (35.7%) of the patients belonged to 55-59 years group but prevalence was highest in 70-75 years of age. Maximum patients (48.1%) sustained fracture at only one vertebra. Highest number of fracture (61.1%) was found in the dorsolumbar region. Most of the fracture (44.8%) was of biconcave shape. Most of the wedge deformities were present from 12th thoracic and above and majority of the biconcave deformities were from 11th thoracic and below. Conclusion: Although the prevalence was low in comparison to other studies, it showed a great burden on our social life. The most important step in treating vertebral compression fractures is prevention and treatment of osteoporosis. Chatt Maa Shi Hosp Med Coll J; Vol.18 (2); July 2019; Page 49-53

scholarly journals Spinal Intraosseous Epidural Arteriovenous Fistula; A Late Complication of Vertebral Compression Fracture: Two Case Reports

2020 ◽  
Author(s):  
Ting Wang ◽  
Seidu A Richard ◽  
Jiao He ◽  
Changwei Zhang ◽  
Chaohua Wang ◽  
...  
Keyword(s):  
Traffic Accidents ◽  
Road Traffic ◽  
Case Reports ◽  
Late Complication ◽  
Compression Fracture ◽  
Pathological Process ◽  
Lower Limbs ◽  
Vertebral Compression Fractures ◽  
Arteriovenous Fistulas ◽  
Magnetic Resonance Imaging Mri

Introduction: Spinal epidural arteriovenous fistulas (SEDAVFs) are extremely rare and the pathological process still remains unclear. Nevertheless, neurofibromatosis, surgery, as well as trauma have been implicated as causes. Nevertheless, long standing chronic vertebral compression fractures (VCFs) as a cause of SEDAVFs has not been reported in literature. Case Presentation: Our cases comprised of a male and female with ages 67 and 62 year respectively. They presented with weakness of bilateral lower extremities and back pain. Their symptoms deteriorated into mild recto-bladder dysfunction as well as hypoesthesia of lower limbs. They both had history of road traffic accidents (RTAs) prior to their symptomatology. In both cases, Magnetic resonance imaging (MRI) revealed VCFs prior to the above symptomatology. Spinal digital subtraction angiography (DSA) was used to confirm SEDAVFs in both cases. We utilized the trans-arterial route with Onyx embolization agent to obliterate both fistulae and their symptom resolved after the embolization. Two-years follow-ups revealed no recurrence of their fistulae. Conclusion: The initial long standing VCFs caused by trauma resulted in perforation of the dorsal somatic branches of the radicular artery leading to the occurrences of SEDAVFs in our cases.

scholarly journals Simultaneous-onset infectious spondylitis with vertebral fracture mimicking an acute osteoporotic vertebral fracture erroneously treated with balloon kyphoplasty: illustrative case

2021 ◽  
Vol 2 (12) ◽  
Author(s):  
Noritaka Yonezawa ◽  
Yuji Tokuumi ◽  
Nobuhiko Komine ◽  
Takaaki Uto ◽  
Yasumitsu Toribatake ◽  
...  
Keyword(s):  
Back Pain ◽  
Vertebral Fracture ◽  
Compression Fracture ◽  
Balloon Kyphoplasty ◽  
Illustrative Case ◽  
Osteoporotic Vertebral Fracture ◽  
Paravertebral Abscess ◽  
Preoperative Magnetic Resonance ◽  
Magnetic Resonance Imaging Mri ◽  
Infectious Spondylitis

BACKGROUND Early balloon kyphoplasty (BKP) intervention for acute osteoporotic vertebral fracture (OVF) has been reported to be more effective than the conservative treatment. However, complications of early BKP intervention are still unknown. OBSERVATIONS A 71-year-old patient with OVF of L2 underwent BKP 2 weeks after symptom onset. Preoperative magnetic resonance imaging (MRI) and radiograph were compatible with new L2 OVF. Although computed tomography (CT) images revealed the atypical destruction of lower endplate of L2 as OVF, L2 BKP was planned. After BKP, his back pain improved dramatically. Two weeks after BKP, his lower back pain recurred. MRI and CT confirmed the diagnosis of infectious spondylitis with paravertebral abscess formation. With adequate antibiotic treatment and rehabilitation, he was symptom-free and completely ambulatory without signs of infection. LESSONS Signal changes on the fractured vertebral bodies during initial MRI and fractured vertebral instability on radiograph can mislead the surgeon to interpret the infection as a benign compression fracture. If the patients exhibit unusual destruction of the endplate on CT imaging, “simultaneous-onset” spondylitis with vertebral fracture should be included in the differential diagnosis. To determine the strategy for OVF, preoperative biopsy is recommended if simultaneous-onset spondylitis with vertebral fracture is suspected.

scholarly journals Treatment of subacute osteoporotic vertebral compression fractures with percutaneous vertebroplasty: A case report

2018 ◽  
Vol 75 (10) ◽  
pp. 1049-1053
Author(s):  
Zoran Aleksic ◽  
Ivana Stankovic ◽  
Ivana Zivanovic-Macuzic ◽  
Dejan Jeremic ◽  
Aleksandar Radunovic ◽  
...  
Keyword(s):  
Case Report ◽  
Vertebral Body ◽  
Percutaneous Vertebroplasty ◽  
Compression Fracture ◽  
Vertebral Compression Fractures ◽  
Minor Trauma ◽  
Osteoporotic Vertebral Compression Fractures ◽  
Invasive Approach ◽  
Compression Fractures ◽  
Thoracic Spinal

Introduction. Percutaneous vertebroplasty (PVP), as a mini-invasive approach in the treatment of patients with osteoporotic vertebral compression fractures (OVCFs), provides stabilization of the spine and relives pain. The most commonly it is applied in the 3?6 weeks before bending of the spine. Complete cessation of pain is easier to achieve if you treat ?less mature? fractures. The aim of the report is to show that PVP is effective and safe for old fractures too. Case report. A 77-old patient suffered from a stable compression fracture of 3th lumbar (L3) vertebral body after minor trauma. This fracture was clinically and radiologically diagnosed. The conservative treatment that included lumbo-sacral orthosis (LSO), analgesic drugs and physical therapy, was primarily applied due to permanent pain and type of fracture. After a period of two months, pain persisted, but it was localized in a thoracic spinal segment with radiologically diagnosed fractured bodies of 8th (Th8) and 10th (Th10), thoracic vertebra without neurological deficit. Thoraco-lumbo-sacral orthosis (TLSO) was prescribed and after six months the indication for vertebroplasty of the Th8 and Th10 vertebral body was given. The pain relief had been achieved and the patient was discharged from the Clinic for Orthopedics on the postoperative day 2, and was symptom free during the follow-up period. Conclusion. In patients with stable OVCFs, PVP is an effective therapy for reducing pain and improving mobility of 6 months old fractures.

Rare Huge Epidural Hematoma Associated with Re-fracture of Kummell Disease: A Case Report and Literature Review

2020 ◽  
Author(s):  
Lu Lu Bai ◽  
Wen Tao Wang ◽  
Xu Kai Xue ◽  
Jin Peng Du ◽  
Ding Jun Hao ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Epidural Hematoma ◽  
Pathological Examination ◽  
Spinal Epidural Hematoma ◽  
Vertebral Compression Fractures ◽  
Minor Trauma ◽  
Low Back ◽  
Activity Restriction ◽  
Spinal Epidural

Abstract Background Kummell disease combined with huge spinal epidural hematoma is a very rare phenomenon, and its potential pathogenesis and natural course remain unclear.Case description We describe a rare case of Kummell disease with huge spinal epidural hematoma. A 75-year-old male was diagnosed with osteoporotic vertebral compression fractures and was treated conservatively. After suffering minor trauma again 8 days ago, he presented unbearable low back pain and activity restriction. Lumbar MRI showed that L1 vertebral had re-fracture and intervertebral vacuum cleft, and a huge spinal epidural hematoma extending from T12- L1. Due to the patient had no neurological deficits and unbearable low back pain, percutaneous vertebroplasty was performed, and pain was relieved significantly. The follow-up MRI showed that the hematoma almost disappeared 7 days after the operation.Conclusion Although extremely rare, there is a possibility of spinal epidural hematoma after re-fracture of Kummell disease, and it could be further confirmed via MRI and pathological examination. Timely operation is recommended, and the results are usually favorable.

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