Percutaneous Pedicle Screw Fixation with Bone Cement Augmentation Below Epidural Anesthesia for Remedy of Kümmell Illness in Extraordinarily Outdated Age.
World Neurosurg. 2018 Jun 19;:
Authors: Lee Okay, Adsul N, Kim HS, Pee YH, Lee KL, Jang IT
BACKGROUND: In circumstances of Kümmell illness with out neurologic deficit, percutaneous vertebroplasty or kyphoplasty has achieved short-term favorable outcomes. In the long run, recollapse of the augmented vertebral physique and aggravation of kyphosis on the index stage is commonly reported. Owing to medical comorbidities, aged sufferers are sometimes unsuited for intensive open backbone surgical procedure beneath basic anesthesia.
CASE DESCRIPTION: A 95-year-old man offered with a 1-month historical past of intractable again ache and gait disturbance. Magnetic resonance imaging revealed intravertebral avascular necrosis with fluid assortment on the L4 vertebra. After postural discount utilizing a pillow within the supine place for two days, percutaneous pedicle screw fixation with bone cement augmentation was carried out on the L3-5 stage together with L4 fracture beneath epidural anesthesia. Extra posterior column compression was carried out to realize restoration of spinal canal and lumbar lordosis. Extreme again ache was lowered after surgical procedure, and the affected person was in a position to stroll the day after surgical procedure.
CONCLUSIONS: To our data, that is the primary case of Kümmell illness in a particularly aged affected person in whom good scientific outcome was obtained after postural discount, vertebral augmentation, and quick section percutaneous pedicle screw fixation beneath epidural anesthesia.
PMID: 29929027 [PubMed – as supplied by publisher]