Treatment of subacute osteoporotic vertebral compression fractures with percutaneous vertebroplasty – A case report

Zoran Aleksić; Ivana Stanković; Ivana Živanović-Mačužić; Dejan Jeremić; Aleksandar Radunović; Zoran Milenković; Andjelka Stojković; Aleksandra Simović; Ivan Stojadinović; Maja Vulović

doi:10.2298/VSP170130037A

Zoran Aleksić University Clinical Center of Republic of Srpska, Clinic for General and Abdominal Surgery, Banja Luka, Bosnia and Herzegovina
Ivana Stanković Ambulance of Brigade of Guards, Belgrade, Serbia
Ivana Živanović-Mačužić Clinical Center of Kragujevac, Kragujevac, Serbia
Dejan Jeremić University of Kragujevac, Department of Anatomy and Forensic Medicine, Kragujevac, Serbia
Aleksandar Radunović Military Medical Academy, Clinic for Orthopedic Surgery, Belgrade, Serbia
Zoran Milenković Clinical Center of Kragujevac, Department of Orthopedics and Traumatology, Kragujevac, Serbia
Andjelka Stojković University of Kragujevac, Faculty of Medical Sciences, Kragujevac, Serbia
Aleksandra Simović University of Kragujevac, Faculty of Medical Sciences, Kragujevac, Serbia
Ivan Stojadinović Military Medical Academy, Clinic for Orthopedic Surgery, Belgrade, Serbia
Maja Vulović Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia

DOI: https://doi.org/10.2298/VSP170130037A

Keywords: spinal fractures;, fractures, compression;, osteoporosis;, pain;, vertebroplasty;, treatment outcome.

Abstract

Abstract

Introduction. Percutaneous vertebroplasty (PVP), as a mini-invasive approach in the treatment of patients with osteoporotic vertebral compression fractures (OVCFs), provides stabilization of the spine and relives pain. The most commonly it is applied in the 3–6 weeks before bending of the spine. Complete cessation of pain is easier to achieve if you treat “less mature” fractures. The aim of the report is to show that PVP is effective and safe for old fractures too. Case report. A 77-old patient suffered from a stable compression fracture of 3th lumbar (L3) vertebral body after minor trauma. This fracture was clinically and radiologically diagnosed. The conservative treatment that included lumbo-sacral orthosis (LSO), analgesic drugs and physical therapy, was primarily applied due to permanent pain and type of fracture. After a period of two months, pain persisted, but it was localized in a thoracic spinal segment with radiologically diagnosed fractured bodies of 8th (Th8) and 10th (Th10), thoracic vertebra without neurological deficit. Thoraco-lumbo-sacral orthosis (TLSO) was prescribed and after six months the indication for vertebroplasty of the Th8 and Th10 vertebral body was given. The pain relief had been achieved and the patient was discharged from the Clinic for Orthopedics on the postoperative day 2, and was symptom free during the follow-up period. Conclusion. In patients with stable OVCFs, PVP is an effective therapy for reducing pain and improving mobility of 6 months old fractures.

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