Article Text
PDF
Abstract
Please confirm that an ethics committee approval has been applied for or granted: Not relevant
Background and Aims Painful Vertebral compression fractures without neurological involvement caused by severe osteoporosis can significantly burden patients. The severe pain, deformity and limited mobility affect their quality of life significantly.Most of these patients are offered Oral analgesics, Supportive devices, Psychological support, Lifestyle Modifications, Physical therapy, Osteoporosis treatments and in refractory cases Vertebroplasty/Kyphoplasty.
Methods A 82 year old lady with severe debilitating pain in her lower back, abdomen and bilateral thighs since 2 years presented to us for pain relief. she was in severe pain with NRS 10/10, wheel chair bound with severe functional limitation. X-Ray and CT SCAN Lower thoracic spine and lumbosacral spine AP & Lateral view showed severe compression fracture D1, D6, D 10, D 11, L1,L2, L3.She was planned for vertebroplasty at D11 and L3 level. She also had fixed flexion deformity at both knee and very tight hamstrings making positioning of the patient very challenging.
Results We performed vertebroplasty at both T11 and L3 levels simultaneously. After obtaining written informed consent from the patient we performed fluoroscopy guided Needle insertion of 11 G at both side pedicles of T11 as well as L3 level. PMMA was injected through the needles in the lateral view simultaneously and procedure was completed with all aseptic precautions. She had good pain relief with NRS 2-3. She was admitted for a day then discharged home with low pain scores NRS: 1/10.
Conclusions in a resource limited setting where patients suffering from severe osteoporotic compression fracture pain, even in compression <50%, vertebroplasty has a significant role.
X-ray showing compression fracture at D11 and L3
Image showing Post vertebroplasty cement at D11 and L3