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

Hyoung Bok Kim; Hoon-Jae Chung

doi:10.4184/jkss.2019.26.1.21

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

Case Report

Journal of Korean Spine Surg 2019;26(1):21-25.

Published online: 31 March 2019

DOI: https://doi.org/10.4184/jkss.2019.26.1.21

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

Hyoung Bok Kim, M.D., Hoon-Jae Chung, M.D.

Department of Orthopedic Surgery, Bumin Hospital, Seoul, Korea

Corresponding author: Hyoung Bok Kim, M.D. ORCID ID: Hyoung Bok Kim: https://orcid.org/0000-0001-6798-6386 Department of Orthopaedic Surgery, Bumin Hospital, 389, Gonghang-daero, Gangseo-gu, Seoul, Korea TEL: +82-2-2620-0003, FAX: +82-2-2620-0100 E-mail: esshappy@daum.net

Received 16 September 201816 October 2018 Accepted 22 December 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.

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Keywords: Unilateral biportal endoscopy, Osteoporotic vertebral fracture

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.

2. 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):153741.

3. 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):557–68. DOI: 10.1056/NEJMoa0900429.

4. 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):32–5. DOI: 10.3340/jkns.2015.57.1.32.

5. 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):1005–10. DOI: 10.3346/jkms.2008.23.6.1005.

6. 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):E717–20. DOI: 10.1097/BRS.0b013e31817f8d40.

7. 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):602–7. DOI: 10.3171/2015.7.SPINE15304.

8. Choi DJ, Kim JE, Jung JT, et al. Biportal Endoscopic Spine Surgery for Various Foraminal Lesions at the Lumbosa-cral Lesion. Asian Spine J. 2018 Jun; 12(3):569–73. DOI: 10.4184/asj.2018.12.3.569.

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Fig. 1.

An X-ray showing degenerative scoliosis and compression defor-mity at L3.

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Fig. 2.

Magnetic resonance imaging (MRI) findings. (A) MRI shows an acute compression fracture at L3 with a fracture line (arrow) in the infe-rior 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).

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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.

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Fig. 3.

The patient underwent percutaneous vertebroplasty at L3.

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Fig. 5.

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

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