ABSTRACT

Main indication for kyphoplasty which is very popular treatment recently, is painful compression fractures. İn the osteoporotic burst fractures that have retropulsed bone fragment in spinal canal with severe posterior wall fragmentation, kyphoplasty has great risk for developing neurologic defisit because of the probability of cement flowing into spinal canal during the application. Furthermore, kyphoplasty is contraindicated for severe kyphotic deformities. In this case report, we present a 73 years old female patient who had L1 osteoporotic burst fracture and L2 ad L3 osteoporotic compression fractures with incomplet neulogic deficit. Anterior decompresion, L1 corpectomy, and anterior strut grafting with 4 costal autograft had performed. Also open kyphoplasty for L1 and 3rd generation posterior transpedicular screw instrumentation and posterior fusion between T12 and L3 vertebrae had performed to the patient. Neurologic deficit of the patient was improved and pain was dissappered postoperatively. According to these datas; we suggest that anterior decompression, strut grafting, open kyphoplasty to adjacent vertebrae and posterior instrumention should be performed to the patients who have osteoporotic burst fractures with neurologic deficits. With these surgical procedures, sagittal contours can be successfully repaired and rigid fixation can be provided, and also the risks of anterior graft resorption and sinking into adjacent can be reduced with kyphoplasty to adjacent vertebrae.