Zeng Yongfen, Wang Shujiang, Lv Xueqing, Cheng Zhuqiang
Department of Pain, Nanjing Jinling Hospital, Nanjing 210003, China.
Department of Pain, Nanjing Jinling Hospital, Nanjing 210003, China; Department of Anesthesiology, The Fourth Affiliated Hospital of Nanjing Medical University, Nanjing 210031, China.
Int J Surg Case Rep. 2025 Aug;133:111535. doi: 10.1016/j.ijscr.2025.111535. Epub 2025 Jun 19.
This paper documents a case of low back pain(LBP) in an elderly female patient caused by coronal split-compression fractures of the thoracolumbar spine with anterior bony bridge disruption. The report comprehensively elaborates on the diagnostic approaches, treatment strategies and postoperative rehabilitation trajectory to emphasize the importance of meticulous clinical physical examination and appropriate imaging examination for physicians.
A 65-year-old female was admitted for severe LBP. She had a five-year history of LBP exacerbated by bending and lifting. After a series of diagnostic procedures, the patient was ultimately diagnosed with vertebral fracture accompanied by anterior vertebral bridge fracture, and also with osteoporosis. She underwent posterior open reduction and pedicle screw fixation at T12-L2. Her pain vanished and motor function improved after surgery.
It is imperative to ascertain the existence of spinal fractures, osteoporosis and additional conditions for patients with LBP. Despite the significant role of Magnetic Resonance Imaging (MRI) plain scans in diagnosing spinal conditions, spinal X-rays, computed tomography (CT) scans and MRI fat-suppressed images offer more precise diagnostic information for LBP, thereby enabling the selection of the most suitable treatment regimen.
Clinicians should conduct bone density tests, spinal X-rays, CT scans and MRI sequences to accurately diagnose and treat LBP patients.
本文记录了一例老年女性患者因胸腰椎冠状面劈裂压缩性骨折伴前方骨桥破坏导致的腰痛(LBP)病例。该报告全面阐述了诊断方法、治疗策略及术后康复过程,以强调临床体格检查细致及影像检查恰当对医生的重要性。
一名65岁女性因严重腰痛入院。她有五年腰痛病史,弯腰和提重物会加重疼痛。经过一系列诊断程序,患者最终被诊断为椎体骨折伴前方椎体桥骨折,同时患有骨质疏松症。她接受了T12-L2后路切开复位椎弓根螺钉固定术。术后她的疼痛消失,运动功能改善。
对于腰痛患者,必须确定是否存在脊柱骨折、骨质疏松症及其他情况。尽管磁共振成像(MRI)平扫在诊断脊柱疾病中作用显著,但脊柱X线、计算机断层扫描(CT)及MRI脂肪抑制图像能为腰痛提供更精确的诊断信息,从而有助于选择最合适的治疗方案。
临床医生应进行骨密度检测、脊柱X线、CT扫描及MRI序列检查,以准确诊断和治疗腰痛患者。