Posterior spinal shortening for paraplegia after vertebral collapse causedby osteoporosis

Study Design. Case report of a patient who underwent a new surgical procedu re for paraplegia after vertebral collapse due to osteoporosis. Objectives. To propose a new approach to posterior spinal fusion surgery fo r osteoporotic patients. Summary of Background Data. Surgical treatment was performed on a paraplegi c patient after vertebral collapse due to osteoporosis. However, the surger y was difficult because implants such as hooks and screws often dislodged d uring the treatment. The poor holding power of these implants to the osteop orotic spine is a challenging problem in this treatment. Methods. When a fractured vertebra is shortened by resecting the posterior part of the spine and the application of a compression force, a short verte bra is produced. As a result, the thoracic kyphosis decreases a nd the forc e pushing the upper thoracic spine inferio-ventrally also decreases. Results. A 74-year-old woman with T12 vertebral collapse was treated with t his new method. Lateral Cobb angle (T10-L2) was reduced from 26 to 4 degree s after surgery. The shortened vertebral body united, and after 33 months, the implant had not dislodged and no loss of correction was seen. Conclusion. The posterior spinal shortening can be a choice for treating de layed paraplegia after osteoporotic vertebral fracture.