Picazo D Ruiz, Villaescusa J Ramírez, Martínez E Portero, Pérez F Doñate
Complejo Hospitalario Universitario de Albacete, Hermanos Falcó, No 37, 02006, Albacete, Spain,
Eur Spine J. 2014 Dec;23(12):2696-702. doi: 10.1007/s00586-013-2751-3. Epub 2013 Jun 19.
Vertebral fracture is a frequent phenomenon in people with osteoporosis and does not lead to clinical problems in most cases. Only a small number of patients suffer from serious neurological complications related to late collapse. Acute or subacute painful osteoporotic vertebral fracture can be tackled using reinforcement techniques; however, neural compression by displaced bone fragments and late kyphosis can produce neurological deficit and require surgical decompression and stabilization. The identification of risk factors associated with a patient's poor recovery is important for adequate treatment. In elderly patients, both the morbidity of the approach and the difficulty of stabilization are the main drawbacks. We present here a case study of an osteoporotic fracture in an elderly man with severe late collapse and neurological impairment. A posterior approach was used with bilateral posterior transpedicular decompression and instrumented arthrodesis with cemented pedicle screws. The post-operative period was incident-free and the patient recovered the neurological deficit and the ability to walk.
椎体骨折在骨质疏松患者中很常见，大多数情况下不会导致临床问题。只有少数患者会出现与晚期塌陷相关的严重神经并发症。急性或亚急性疼痛性骨质疏松性椎体骨折可采用强化技术处理；然而，移位的骨碎片导致的神经受压和晚期脊柱后凸可产生神经功能缺损，需要手术减压和稳定。识别与患者恢复不佳相关的风险因素对于充分治疗很重要。在老年患者中，手术入路的发病率和稳定的难度是主要缺点。我们在此介绍一例老年男性骨质疏松性骨折的病例研究，该患者伴有严重的晚期塌陷和神经功能损害。采用后路入路，进行双侧后路经椎弓根减压，并使用骨水泥椎弓根螺钉进行器械固定融合术。术后无并发症，患者恢复了神经功能缺损并恢复了行走能力。
