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Case Reports
. 2024 Aug 31;16(8):e68262.
doi: 10.7759/cureus.68262. eCollection 2024 Aug.

Challenges in Orthopedic Surgical Decision-Making for Multilevel Vertebrae Fractures

Michelle O Uwefoh  1 , Elizabeth Edah  2 , Lee-Ann D Charles  3 , Elvis Gini  4 , Ekama Isong  5 , Deborah A Ademo  6 , Omavuaye J Eruvwedede  1 , Daniel Ivankovich  7
Affiliations
Case Reports

Challenges in Orthopedic Surgical Decision-Making for Multilevel Vertebrae Fractures

Michelle O Uwefoh et al. Cureus. .

Abstract

Vertebral fractures commonly occur in postmenopausal women due to decreased bone density, a condition known as osteoporosis. They can occur after minimal trauma or even during routine activities. Vertebral fractures occur predominantly in individuals with a high fall risk. This case report explores the clinical complexities surrounding a 65-year-old female patient with a history of multilevel vertebrae fractures compounded by a history of chronic smoking, osteoporosis, multiple falls, and evident signs of osteopenia on X-ray. These risk factors complicate the decision to perform surgery and highlight the importance of constantly weighing the benefits and possible risks. This paper aims to emphasize the gender-specific challenges healthcare providers encounter when assessing surgical risks in the context of postmenopausal females with significant comorbidities. It underlines the need for tailored and comprehensive care strategies to manage orthopedic conditions in high-risk female individuals, further aligning with one of the World Health Organization's concerns on addressing gender-specific health considerations.

Keywords: comorbidities; decision making; female; multilevel fractures; surgery.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. X-ray imaging showcasing healed fracture of the femur with hardware in-situ
Figure 2
Figure 2. X-ray imaging showcasing healed fracture of the femur with hardware in-situ
Figure 3
Figure 3. X-ray imaging showcasing healed fracture of the femur with hardware in-situ
Figure 4
Figure 4. X-ray imaging showcasing compression fractures at T11, T12, and L1 levels, as well as degenerative scoliosis of the thoracolumbar spine
Figure 5
Figure 5. X-ray imaging showcasing fracture of the surgical neck of the left humerus
Figure 6
Figure 6. X-ray imaging showcasing degenerative scoliosis and stenosis at L3-L4 level, as well as an L1 fracture
Figure 7
Figure 7. X-ray imaging showcasing fracture of the proximal phalanx of the left great toe
See this image and copyright information in PMC

References

    1. The association of radiographically detected vertebral fractures with back pain and function: a prospective study. Nevitt MC, Ettinger B, Black DM, et al. Ann Intern Med. 1998;128:793–800. - PubMed
    1. Recognition of osteoporosis by primary care physicians. Gehlbach SH, Fournier M, Bigelow C. Am J Public Health. 2002;92:271–273. - PMC - PubMed
    1. The socioeconomic burden of fractures: today and in the 21st century. Johnell O. Am J Med. 1997 Aug 18;103(2A):20–25. - PubMed
    1. Barriers to osteoporosis identification and treatment among primary care physicians and orthopedic surgeons. Simonelli C, Killeen K, Mehle S, Swanson L. Mayo Clin Proc. 2002;77:334–338. - PubMed
    1. Vertebral compression fractures: a review of current management and multimodal therapy. Wong CC, McGirt MJ. J Multidiscip Healthc. 2013;6:205–214. - PMC - PubMed

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