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Non-operative Treatment of Osteoporotic Thoracolumbar Extension-distraction Fracture Using Teriparatide in Elderly Female Patient with Severe Osteoporosis under Inoperable Condition: A Case Report
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논문 기본 정보

Type
Academic journal
Author
Insu Seong (Department of Neurosurgery Yeungnam University Hospital Yeungnam University College of Medicine D) Ik Chan Jeon (Department of Neurosurgery Yeungnam University Medical Center Yeungnam University Medical School)
Journal
대한신경손상학회 Korean Journal of Neurotrauma Korean Journal of Neurotrauma Vol.17 No.1 KCI Accredited Journals
Published
2021.1
Pages
70 - 74 (5page)

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Non-operative Treatment of Osteoporotic Thoracolumbar Extension-distraction Fracture Using Teriparatide in Elderly Female Patient with Severe Osteoporosis under Inoperable Condition: A Case Report
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Vertebral extension-distraction fractures are a type of unstable fracture and require surgical stabilization with instrumentation. Unfortunately, in elderly patients with severe osteoporosis, poor bone quality can be related to postoperative pseudo-arthrosis and instability. Teriparatide is known as an effective anabolic agent for bone healing, union, and managing osteoporosis. In this report, we describe a rare case of extension-distraction thoracolumbar fractures in 86-year-old female patient with severe osteoporosis, which was treated conservatively. The patient was inoperable due to the presence of concomitant cardiopulmonary problems and the patients' old age. She had poor bone quality on bone mineral densitometry (−6.7, lumbar spine) but no neurologic defcits. As conservative treatment, bedrest and pain control were frst performed for three weeks along with the use of teriparatide for 6-month and supplementation of calcium and vitamin D. Aferwards, sitting and standing with wearable orthoses were gradually implemented. Afer 1 year, the patient achieved bone fusion and was able to walk by herself, and there was radiological correction of the initial segmental lordotic curvature and disappearance of the intravertebral gap caused by the extension-distraction fracture.
#Spine #Fracture #Teriparatide #Extension-distraction injury #Osteoporosis

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References (18)

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Burke DC / 1971 / Hyperextension injuries of the spine / J Bone Joint Surg Br 53:3~12 google schola Elgafy H / 2007 / Three-column ligamentous extension injury of the thoracic spine: a case report and review of the literature / Spine (Phila Pa 1976) 32:E785~E788 google schola Hall SE / 1999 / A case-control study of quality of life and functional impairment in women with long-standing vertebral osteoporotic fracture / Osteoporos Int 9:508~515 google schola Halvorson TL / 1994 / Effects of bone mineral density on pedicle screw fixation / Spine (Phila Pa 1976) 19:2415~2420 google schola Jae Wook Kim / 2018 / The Effect of Postoperative Use of Teriparatide Reducing Screw Loosening in Osteoporotic Patients / 대한신경외과학회지 61(4):494~502 Crossref

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