Cortical screw trajectory for instrumentation and fusion in the setting of osteopathic compression fracture allows for percutaneous kyphoplasty for adjacent level compression fractures

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
Donato PacioneAnthony Frempong-Boadu

Abstract

Spinal fixation in the osteoporotic patient can be challenging due to the poor trabecular bone quality of the vertebral body. Patients with osteoporotic vertebral body compression fractures are at risk for future compression fractures at adjacent levels, especially after cement augmentation. The purpose of this technical report is to describe the utilization of a cortical screw trajectory along with kyphoplasty for a patient with an osteoporotic compression fracture as well as degenerative spinal disease. This trajectory allows for the possibility of percutaneous pedicle access in the event of future compression fractures. Our patient underwent a decompressive laminectomy and kyphoplasty at the level of an osteoporotic compression fracture. The fracture was stabilized with cortical screw instrumentation and fusion at a level above and a level below the fracture. Subsequently the patient developed an adjacent level fracture within the fusion construct. Due to the utilization of a cortical screw trajectory for the initial fusion, the traditional pedicle trajectory was still accessible. As a result, the new fracture was treated with a percutaneous kyphoplasty through a standard pedicle trajectory. In conclusion, the use of a corti...Continue Reading

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Citations

Sep 28, 2015·The Spine Journal : Official Journal of the North American Spine Society·Wayne K ChengOlumide A Danisa
Nov 3, 2017·Asian Spine Journal·Juan Delgado-FernandezRafael G Sola
Jun 6, 2021·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Kevin K KumarHarminder Singh

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