Eur Spine J (2017) 26 (Suppl 5):S553–S554 https://doi.org/10.1007/s00586-017-5334-x OPEN OPERATING THEATRE (OOT) Posterior long segment stabilization of an adjacent insufficiency fracture 1 1 Andreas Pingel · Frank Kandziora © Springer-Verlag GmbH Germany 2017 Keywords Osteoporotic fracture · Adjacent level fracture · Case description Surgical decision · Thoracic spine fracture · Cement aug- mented screws This 80-year-old woman experienced acute back pain 5 weeks after stabilization of a T9 fracture. On admission, she suffered from back pain in thoracolumbar junction, Learning targets How to do a posterior long seg- right below the former stabilization region. No neurologic ment stabilization of an adjacent insufficiency fracture by deficits were observed. Radiological diagnostics including cement augmented pedicle screws connected with a former plain X-ray in standing position and CT scans of the tho- implanted instrumentation. racic and lumbar spine, revealed an adjacent hyperflexion insufficiency fracture of T11/12 (AOS B2) [6 ]. In standing position, there was a kyphotic angle of 35° between Th1 and Introduction T12. In contrast, CT scan showed a monosegmental angle T11/12 of 12°, indicating a significant instability. Bone den- Pathologic fractures in adjacent vertebra after instrumen- sity was decreased (T-score −3.94 SD) tation of osteoporotic spine are not uncommon. The risk to suffer from a second osteoporotic
European Spine Journal – Springer Journals
Published: Oct 24, 2017
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