Open Access, Peer-reviewed
pISSN 2093-4378
eISSN 2093-4386
    J Korean Soc Spine Surg. 2019 Mar;26(1):21-25. Korean.
    Published online Mar 31, 2019.
    https://doi.org/10.4184/jkss.2019.26.1.21
    © Copyright 2019 Korean Society of Spine Surgery
    Case Report

    Unilateral Biportal Endoscopy as a Treatment for Acute Radiculopathy after Osteoporotic Lumbar Compression Fracture: A Case Report

    Hyoung Bok Kim, M.D., and Hoon-Jae Chung, M.D.
      • Department of Orthopedic Surgery, Bumin Hospital, Seoul, Korea.
    • Corresponding author: Hyoung Bok Kim, M.D. Department of Orthopaedic Surgery, Bumin Hospital, 389, Gonghang-daero, Gangseo-gu, Seoul, Korea. TEL: +82-2-2620-0003, FAX: +82-2-2620-0100 Email: esshappy@daum.net
    Received September 16, 2018; Revised October 16, 2018; Accepted December 22, 2018.

    This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

    Abstract

    Study Design

    Case report.

    Objectives

    To document unilateral biportal endoscopy (UBE) as a treatment for acute radiculopathy after osteoporotic vertebral fracture.

    Summary of Literature Review

    Acute radiculopathy after osteoporotic vertebral fracture leads to claudication. Treatment of osteoporotic vertebral fractures with accompanying radiating pain is challenging.

    Materials and Methods

    A 74-year-old woman was diagnosed with an osteoporotic vertebral fracture at L3 after slipping and falling. Vertebroplasty was performed for the osteoporotic vertebral fracture at L3. She still complained of right lower extremity radiating pain. UBE was performed to treat acute radiculopathy.

    Results

    Foraminal decompression using UBE was performed at the L3–4 right foraminal area. Her symptoms resolved after surgery.

    Conclusions

    UBE is a useful treatment method for acute radiculopathy after osteoporotic vertebral fracture.

    Keywords
    Unilateral biportal endoscopy; Osteoporotic vertebral fracture

    Figures

    Fig. 1
    An X-ray showing degenerative scoliosis and compression deformity at L3.

    Fig. 2
    Magnetic resonance imaging (MRI) findings. (A) MRI shows an acute compression fracture at L3 with a fracture line (arrow) in the inferior part (1/3) of the vertebral body. (B) A fracture fragment extending to the spinal canal was noted. (C) Severe foraminal stenosis was noted at the L3–4 right foraminal area (arrow head).

    Fig. 3
    The patient underwent percutaneous vertebroplasty at L3.

    Fig. 4
    Unilateral biportal endoscopy was performed. (A) Three-dimensional computed tomography scan for preoperative planning, showing the L3–4 right foraminal area (arrow). (B) The endoscopic view of the foraminal area was the same as in the 3-dimensional image, with this view of the superior articular process of L4 (*). (C) Bony decompression was done. (D) Full decompression was seen at the foraminal area.

    Fig. 5
    Comparison of magnetic resonance imaging findings between the preoperative (A) and postoperative (B) foraminal area.

    References

      1. Tamayo-Orozco J, Arzac-Palumbo P, Peon-Vidales H, et al. Vertebral fractures associated with osteoporosis: patient management. Am J Med 1997 Aug;103 2 Suppl:44–50. [doi: 10.1016/S0002-9343(97)90026-7]
      1. Belkoff SM, Mathis JM, Jasper LE, et al. The biomechanics of vertebroplasty: the effect of cement volume on mechanical behavior. Spine (Phila Pa 1976) 2001 Jul;26(14):1537–1541.
      1. Buchbinder R, Osborne RH, Ebeling PR, et al. A randomized trial of vertebroplasty for painful osteoporotic vertebral fractures. N Engl J Med 2009 Aug;361(6):557–568. [doi: 10.1056/NEJMoa0900429]
      1. Kim DE, Kim HS, Kim SW, et al. Clinical Analysis of Acute Radiculopathy after Osteoporotic Lumbar Compression Fracture. J Korean Neurosurg Soc 2015 Jan;57(1):32–35. [doi: 10.3340/jkns.2015.57.1.32]
      1. Doo TH, Shin DA, Kim HI, et al. Clinical relevance of pain patterns in osteoporotic vertebral compression fractures. J Korean Med Sci 2008 Dec;23(6):1005–1010. [doi: 10.3346/jkms.2008.23.6.1005]
      1. 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) 2008 Sep;33(19):E717–E720. [doi: 10.1097/BRS.0b013e31817f8d40]
      1. Eum JH, Heo DH, Son SK, et al. Percutaneous biportal endoscopic decompression for lumbar spinal stenosis: a technical note and preliminary clinical results. J Neurosurg Spine 2016 Apr;24(4):602–607. [doi: 10.3171/2015.7.SPINE15304]
      1. Choi DJ, Kim JE, Jung JT, et al. Biportal Endoscopic Spine Surgery for Various Foraminal Lesions at the Lumbosacral Lesion. Asian Spine J 2018 Jun;12(3):569–573. [doi: 10.4184/asj.2018.12.3.569]
    MeSH Terms
    Accidental Falls
    Aged
    Decompression
    Endoscopy*
    Female
    Fractures, Compression*
    Humans
    Lower Extremity
    Methods
    Radiculopathy*
    Vertebroplasty
    Metrics
    Share
    Figures
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