R Krishnakumar1, Lawrence G Lenke. 1. *Spine Division, Department of Orthopaedics, Amrita Institute of Medical Sciences, Cochin, Kerala, India; and †Department of Orthopaedic Surgery, Columbia University College of Physicians & Surgeons, New York, New York. Treatment was rendered at Washington University School of Medicine in St. Louis, MO.
Abstract
STUDY DESIGN: A unique case report. OBJECTIVE: To report a case of severe thoracolumbar kyphosis with abdominal compression causing gastric disturbance after treatment of an osteoporotic vertebral compression fracture and its ultimate management by vertebral column resection (VCR). We propose a new terminology "sternum-into-abdomen deformity" to describe this condition. SUMMARY OF BACKGROUND DATA: Management of osteoporotic vertebral compression fractures mainly aims at pain control and deformity reduction. VCR for decreasing abdominal compression due to the development of severe kyphosis after treatment of osteoporotic compression fractures has never been reported in the literature to our knowledge. METHODS: This is a case report on a single patient. The hospital and office charts were reviewed. Reports of prior treatment of his compression fracture were analyzed. RESULTS: This 73-year-old cachectic patient underwent vertebroplasty for a midthoracic compression fracture with progressive, severe kyphosis. His condition worsened and spinal reconstruction with a 2-level VCR restored more normal sagittal alignment and decreased his gastric compression. His back pain decreased and his ability to tolerate oral intake returned. CONCLUSION: We propose the term "sternum-into-abdomen deformity" to describe this type of severe kyphosis with abdominal compression. Treatment with a VCR and fusion for realignment of focal kyphosis can improve the quality of life for patients with this condition. LEVEL OF EVIDENCE: 5.
STUDY DESIGN: A unique case report. OBJECTIVE: To report a case of severe thoracolumbar kyphosis with abdominal compression causing gastric disturbance after treatment of an osteoporotic vertebral compression fracture and its ultimate management by vertebral column resection (VCR). We propose a new terminology "sternum-into-abdomen deformity" to describe this condition. SUMMARY OF BACKGROUND DATA: Management of osteoporotic vertebral compression fractures mainly aims at pain control and deformity reduction. VCR for decreasing abdominal compression due to the development of severe kyphosis after treatment of osteoporotic compression fractures has never been reported in the literature to our knowledge. METHODS: This is a case report on a single patient. The hospital and office charts were reviewed. Reports of prior treatment of his compression fracture were analyzed. RESULTS: This 73-year-old cachectic patient underwent vertebroplasty for a midthoracic compression fracture with progressive, severe kyphosis. His condition worsened and spinal reconstruction with a 2-level VCR restored more normal sagittal alignment and decreased his gastric compression. His back pain decreased and his ability to tolerate oral intake returned. CONCLUSION: We propose the term "sternum-into-abdomen deformity" to describe this type of severe kyphosis with abdominal compression. Treatment with a VCR and fusion for realignment of focal kyphosis can improve the quality of life for patients with this condition. LEVEL OF EVIDENCE: 5.
Authors: Marc Dreimann; Axel Hempfing; Martin Stangenberg; Lennart Viezens; Lukas Weiser; Patrick Czorlich; Sven Oliver Eicker Journal: Neurosurg Rev Date: 2017-03-09 Impact factor: 3.042
Authors: Francesco Langella; Jorge Hugo Villafañe; Virginie Lafage; Justin S Smith; Christopher Shaffrey; Han Jo Kim; Douglas Burton; Richard Hostin; Shay Bess; Christopher Ames; Gregory Mundis; Eric Klineberg; Frank Schwab; Renault Lafage; Pedro Berjano Journal: Eur Spine J Date: 2018-01-12 Impact factor: 3.134