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CASE REPORT
Year : 2021  |  Volume : 9  |  Issue : 2  |  Page : 90-93

Correction of kyphosis by overcoming the challenge of pedicle screw fixation in previously augmented vertebrae by vertebroplasty


1 Department of Spine Surgery, Sancheti Institute of Orthopaedics and Rehabilitation, Pune, Maharashtra, India
2 Sancheti Institute of Orthopaedics and Rehabilitation, Pune, Maharashtra, India

Correspondence Address:
Dr. Himanshu Gurunath Kulkarni
Department of Spine Surgery, Sancheti Institute of Orthopaedics and Rehabilitation, 16, 11/12, Shivajinagar, Thube Park, Pune 411005, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JOASP.JOASP_25_21

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Osteoporotic vertebral compression fractures (OVCF) is one of the most common degenerative spine pathologies that a spine surgeon comes across. Percutaneous cement augmented vertebroplasty or Balloon kyphoplasty are one of the most commonly used treatment modalities for OVCF. Spine surgeons may sometimes encounter situations in which they might need to operate for another spinal pathology, such as degenerative spinal instabilities, spinal infections, and neoplasms, which warrant posterior instrumented stabilization in patients who have already undergone vertebroplasty. Passing pedicle screws in these vertebrae can be very difficult and if these levels are skipped, the span of the fixation may increase and involve more normal levels for the sake of the stability of the construct. We present a case of a 49-year-old male with severe back pain, Cushing’s syndrome, and thoracicolumbar kyphosis occurring due to multiple osteoporotic fractures, which had been previously treated with vertebroplasties at five levels. With meticulous preoperative planning with CT scans and whole spine X-rays, pedicle screws were passed in vertebrae that had been previously augmented with vertebroplasty. Kyphosis and sagittal balance were completely corrected, and the patient exhibited significant symptomatic improvement. So, we suggest that even though many surgeons feel that the presence of vertebroplasty contraindicates the placement of pedicle screws in the vertebrae previously treated with vertebroplasty, it is feasible with proper preoperative planning.


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