Posterior Spinal Shortening for Paraplegia After Vertebral Collapse Caused by Osteoporosis

Study Design. Case report of a patient who underwent a new surgical procedure for paraplegia after vertebral collapse due to osteoporosis. Objectives. To propose a new approach to posterior spinal fusion surgery for osteoporotic patients. Summary of Background Data. Surgical treatment was performed on a paraplegic patient after vertebral collapse due to osteoporosis. However, the surgery was difficult because implants such as hooks and screws often dislodged during the treatment. The poor holding power of these implants to the osteoporotic spine is a challenging problem in this treatment. Methods. When a fractured vertebra is shortened by resecting the posterior part of the spine and the application of a compression force, a short vertebra is produced. As a result, the thoracic kyphosis decreases and the force pushing the upper thoracic spine inferio-ventrally also decreases. Results. A 74-year-old woman with T12 vertebral collapse was treated with this new method. Lateral Cobb angle (T10–L2) was reduced from 26 to 4° after surgery. The shortened vertebral body united, and after 33 months, the implant had not dislodged and no loss of correction was seen. Conclusion. The posterior spinal shortening can be a choice for treating delayed paraplegia after osteoporotic vertebral fracture.