Case 9- Non-specific LBP

81 yo/female patient presents with non-specific LBP. No prior  carcinoma or corticosteroid regimen.

What do you see?

The medullary portion of L4 shows an elongated homogenous density . The VB height has been restored post- intervention.
Spondylosis is present at the L3 disc.

XRAY FINDINGS

The medullary portion of L4 shows an elongated homogenous density . The VB height has been restored post- intervention.
Spondylosis is present at the L3 disc.


Vertebral augmentation (VA) consists of 2 types:

a. kyphoplasty – a balloon cavity is created then injected with bone cement. (Polymethylmethacrylate)

b. vertebroplasy – bone cement is into the VCF.

 

Recent data shows low bone mass will affect over 50 million people in the US. Every other person > 50 years of age will have low bone mass or osteoporosis. There is still debate (despite >3000 articles published) on the effectiveness of vertebral augmentation (VA) for osteoporotic compression fractures.

Chandra et al discuss 2 groups of patients that may benefit fromVA.
a. patients with severe pain treated < 6 weeks post trauma.
b. national datasets show patients hospitalized for VCF show earlier hospital release, lower re-admission rates & reduced mortality. (1)

  1. Vertebroplasty & Kyphoplasty for Osteoporotic Vertebral Fractures: What Are Tthe Latest Data?   Chandra May 2018 www. ajnr.org
  2. https://totalspinebrain.com/kyphoplasty-forcompression-fractures/(image above)

Will another DC benefit from this case?

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