Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Clinical Analysis of Acute Radiculopathy after Osteoporotic Lumbar Compression Fracture

  • Kim, Do Eon (Department of Neurosurgery, College of Medicine, Chosun University) ;
  • Kim, Hyeun Sung (Department of Neurosurgery, Heori Sarang Hospital) ;
  • Kim, Seok Won (Department of Neurosurgery, College of Medicine, Chosun University) ;
  • Kim, Hyun Sook (Department of Internal Medicine, Soonchunhyang University College of Medicine)
  • Received : 2014.02.13
  • Accepted : 2014.04.06
  • Published : 2015.01.28
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Abstract

Objective : The purpose of this study was to analyze the relationship between fracture pattern and the development of acute radiculopathy after osteoporotic lumbar compression fracture. Methods : This study included 59 patients who underwent bone cement augmentation for osteoporotic compression fracture below the L2 level, which can lead to radiculopathic radiating pain. The patients were divided into two groups according to the presence of radiculopathy (group A : back pain only; group B : back pain with newly developed radiating pain). We categorized compression fractures into three types by the position of the fracture line. The incidence of newly developed radiculopathy was examined retrospectively for each compression fracture type. Results : The overall incidence of newly developed leg pain (group B) was 25%, and the frequency increased with descending spinal levels (L2 : 0%, L3 : 22%, L4 : 43%, and L5 : 63%). The back pain-only group (group A) had mostly superior-type fractures. On the other hand, the back pain with radiculopathy group (group B) had mostly inferior-type fractures. Most patients in group B showed significant relief of leg pain as well as back pain after bone cement augmentation. Conclusion : The incidence of a newly developed, radiating pain after osteoporotic compression fractures increased gradually from the L3 to L5 levels. Most of these fractures were of the inferior type, and the bone cement augmentation procedures seemed to be sufficient for relief of both back and radiating pain.

Keywords

References

  1. Buchbinder R, Osborne RH, Ebeling PR, Wark JD, Mitchell P, Wriedt C, et al. : A randomized trial of vertebroplasty for painful osteoporotic vertebral fractures. N Engl J Med 361 : 557-568, 2009 https://doi.org/10.1056/NEJMoa0900429
  2. Chung SK, Lee SH, Kim DY, Lee HY : Treatment of lower lumbar radiculopathy caused by osteoporotic compression fracture : the role of vertebroplasty. J Spinal Disord Tech 15 : 461-468, 2002 https://doi.org/10.1097/00024720-200212000-00005
  3. Doo TH, Shin DA, Kim HI, Shin DG, Kim HJ, Chung JH, et al. : Clinical relevance of pain patterns in osteoporotic vertebral compression fractures. J Korean Med Sci 23 : 1005-1010, 2008 https://doi.org/10.3346/jkms.2008.23.6.1005
  4. Dublin AB, Hartman J, Latchaw RE, Hald JK, Reid MH : The vertebral body fracture in osteoporosis : restoration of height using percutaneous vertebroplasty. AJNR Am J Neuroradiol 26 : 489-492, 2005
  5. Farrokhi MR, Alibai E, Maghami Z : Randomized controlled trial of percutaneous vertebroplasty versus optimal medical management for the relief of pain and disability in acute osteoporotic vertebral compression fractures. J Neurosurg Spine 14 : 561-569, 2011 https://doi.org/10.3171/2010.12.SPINE10286
  6. Kanchiku T, Taguchi T, Kawai S : Magnetic resonance imaging diagnosis and new classification of the osteoporotic vertebral fracture. J Orthop Sci 8 : 463-466, 2003 https://doi.org/10.1007/s00776-003-0665-3
  7. Katz JN, Harris MB : Clinical practice. Lumbar spinal stenosis. N Engl J Med 358 : 818-825, 2008 https://doi.org/10.1056/NEJMcp0708097
  8. Lee JH, Kwon JT, Kim YB, Suk JS : Segmental deformity correction after balloon kyphoplasty in the osteoporotic vertebral compression fracture. J Korean Neurosurg Soc 42 : 371-376, 2007 https://doi.org/10.3340/jkns.2007.42.5.371
  9. Miller JD, Nader R : Treatment of combined osteoporotic compression fractures and spinal stenosis : use of vertebral augumentation and interspinous process spacer. Spine (Phila Pa 1976) 33 : E717-E720, 2008 https://doi.org/10.1097/BRS.0b013e31817f8d40
  10. Rao RD, Singrakhia MD : Painful osteoporotic vertebral fracture. Pathogenesis, evaluation, and roles of vertebroplasty and kyphoplasty in its management. J Bone Joint Surg Am 85-A : 2010-2022, 2003

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