JaLCDOI 10.18926/AMO/50414
フルテキストURL 67_3_197.pdf
著者 Yasuhara, Takao| Takahashi, Yuichi| Kumamoto, Shinji| Nakahara, Masayuki| Yoneda, Kotaro| Niimura, Tatsuomi| Tanoue, Takashi| Kusumegi, Akira| Sennari, Takashi| Hijikata, Yasukazu| Manabe, Hiroaki| Miyoshi, Yasuyuki| Date, Isao| Ogawa, Koichi| Nishida, Kenki|
抄録 Some cases with lumbar degenerative diseases require multi-level fusion surgeries. At our institute, 27 and 4 procedures of 3- and 4-level fusion were performed out of a total 672 posterior lumbar interfusions (PLIFs) on patients with lumbar degenerative disease from 2005 to 2010. We present 2 osteoporotic patients who developed proximal vertebral body fracture after 4-level fusion. Both cases presented with gait disability for leg pain by degenerative lumbar scoliosis and canal stenosis at the levels of L1/2-4/5. After 4-level fusion using L1 as the upper instrumented vertebra, proximal vertebral body fractures were found along with the right pedicle fractures of L1 in both cases. One of these patients, aged 82 years, was treated as an outpatient using a hard corset for 24 months, but the fractures were exacerbated over time. In the other patient, posterolateral fusion was extended from Th10 to L5. Both patients can walk alone and have been thoroughly followed up. In both cases, the fracture of the right L1 pedicle might be related to the subsequent fractures and fusion failure. In consideration of multi-level fusion, L1 should be avoided as an upper instrumented vertebra to prevent junctional kyphosis, especially in cases with osteoporosis and flat back posture.
キーワード degenerative lumbar scoliosis osteoporosis pedicle fracture posterior lumbar interbody fusion vertebral body fracture
Amo Type Case Report
発行日 2013-06
出版物タイトル Acta Medica Okayama
67巻
3号
出版者 Okayama University Medical School
開始ページ 197
終了ページ 202
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2013 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 23804144
Web of Sience KeyUT 000320747900010