A 68-year-old female patient slipped and fell in her bathroom three months ago, resulting in back pain and difficulty in walking. She has a history of rheumatoid arthritis and is on steroids. Upon presenting to Dr. Ramachandran, she was diagnosed with ASIA-C paraplegia and a gross angular kyphosis secondary to an osteoporotic fracture of D12. Due to the poor quality of bones in osteoporotic fractures, Dr. Ramachandran decided to use advanced pedicle screws called Fenestrated pedicle screws, which allow for cement augmentation to improve the hold of the screws in the bone.
Instrumented fusion and kyphosis correction with Kyphoplasty were performed with special Fenestrated screws and titanium rods under Intraoperative neural monitoring (IONM) as fixation was mandatory due to the patient’s paraplegia, kyphosis, and significant instability in X-rays. The patient’s condition improved post-surgery, and after three months, she was able to walk with a walker. At the end of six months, she became ambulant without aids.
This case highlights the importance of immediate treatment for osteoporotic fractures of the spine to avoid major issues.
