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Case Reports
. 2018 Dec;97(52):e13846.
doi: 10.1097/MD.0000000000013846.

Modified grade 4 osteotomy for kyphosis due to old osteoporotic vertebral compression fractures: Two case reports

Feng-Yu Liu  1 , Zheng-Qi Zhao  1 , Liang Ren  1 , Zhen-Fang Gu  1 , Feng Li  1 , Wen-Yuan Ding  2 , Xian-Ze Sun  1
Affiliations
Case Reports

Modified grade 4 osteotomy for kyphosis due to old osteoporotic vertebral compression fractures: Two case reports

Feng-Yu Liu et al. Medicine (Baltimore). 2018 Dec.

Abstract

Rationale: The kyphosis caused by old osteoporotic vertebral compression fracture usually requires osteotomy to correct it. Various osteotomy techniques have been reported, but each has its own advantages and disadvantages.

Patient concerns: We reviewed 2 cases of old osteoporotic vertebral compression fractures with kyphosis in our hospital. One patient complained of persistent low-back pain, another patient complained of low-back pain and weakness of both lower extremities.

Diagnosis: Old osteoporotic vertebral compression fractures with kyphosis were diagnosed based on computer tomography and magnetic resonance imaging.

Interventions: We performed modified grade 4 osteotomy for 2 patients.

Outcomes: Both patients said significant improvement in preoperative symptoms, and x-ray showed that the kyphosis was corrected. Both patients were satisfied with the treatment at the last follow-up, and the kyphosis was not aggravated.

Lessons: Modified grade 4 osteotomy is an effective option for the treatment of old osteoporotic fracture with kyphosis. It can restore the spine sequence and achieve better clinical result.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
A 70-year-old female presented with an old L1 fracture and low-back pain. The preoperative MRI and CT showed no obvious spinal cord compression (A, B). She was treated with a posterior fusion from T11-L3 with L1 partial pedicular and upper disc subtraction (C).
Figure 2
Figure 2
The preoperative Cobb angle is 36° (A). The Cobb angle is 6° at 1 week after operation (B). One year of follow-up revealed a Cobb angle of 7° and solid fusion at the osteotomy site.
Figure 3
Figure 3
A 74-year-old male with an old L1 fracture, presented with low-back pain and weakness of both lower extremities. The preoperative MRI and CT showed lumbar disc herniation at L1/2 level (A–C). He was treated with a posterior fusion from T12-L3 with L1 partial vertebra and lower disc subtraction (D).
Figure 4
Figure 4
The preoperative Cobb angle is 27° (A). The Cobb angle is 6° at 1 week after operation (B). One year of follow-up revealed a Cobb angle of 7° and solid fusion at the osteotomy site (C).
See this image and copyright information in PMC

References

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