Osteoporotic Spinal fractures
75 year old patient from Ghaziabad had fall at home followed by fracture in L2 vertebrae in Spine. He was initially treated with rest and taylor brace. But after 4 months of treatment he still had severe back pain that was radiating in his legs and severly restricted his mobility. His fresh MRI showed Nonunion of L2 fracture resulting in large cavity in the bone and disrupted ligaments. This cavity resulted in instabilty causing pain and nerve compression. After counselling, Patient underwent pedicle screw fixation and decompression by Laminectomy at Jaypee Hospital. The cavity inside the bone was filled with bone cement. Patient was gradually mobilised with brace and at 3 months follow up had significant improvement.
Osteoporotic fractures are usually managed non operatively with rest and Brace. Almost 90 % of fractures unite in 3 months. In 10 % cases, it goes into nonunion. Treatment in these case is by Cement Augumentation i.e Vertebroplasty. But cases with disrupted ligaments and large cavity, Vertebroplasty alone will fail and additional screw fixation should be done.