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Ann Geriatr Med Res > Volume 13(2); 2009 > Article
Journal of the Korean Geriatrics Society 2009;13(2):101-105.
DOI: https://doi.org/10.4235/jkgs.2009.13.2.101    Published online June 30, 2009.
Delayed Subsequent Refracture of a Thoracolumbar Vertebral Compression Fracture
Bo Ram Kim, In Sik Lee, Seong Eun Koh, Se Won Kim, Seung Beom Kim, Seon Yu Kim
Department of Rehabilitation Medicine, Konkuk University Medical Center and School of Medicine, Seoul, Korea. mdlis@nate.com
흉추부 척추 압박골절의 지연된 속발성 압박골절
Abstract
Most patients experiencing an osteoporotic vertebral compression fracture remain asymptomatic or minimally symptomatic. However, a notable number of these patients do experience significant pain at some time resulting in disability and decreased quality of life. A 77-year-old man was admitted to a hospital with severe thoracolumbar pain and functional disabilities even though, 12 months ago, he had received inpatient treatment for 6 months in another hospital with the diagnosis of T12 vertebral compression fracture. Although initial outside spine MRI revealed a stable T12 com pression fracture with a 27.6% compression rate, delayed subsequent re-fracture of the same vertebrae was found on simple X-ray and thoracolumbar CT scan with an 86.5% compression rate and retropulsion to the central spinal canal. He continued to have severe spinal pain and functional disabilities in spite of undergoing a first anterolateral fusion one year ago and a subsequent posterior fusion. We emphasize a proper clinical and radiologic examination at one-year follow-up after successful conservative treatment of vertebral compression fractures.
Key Words: Compression fractures, Thoracolumbar, Subsequent refracture
초 록

척추 압박골절은 골다공증성 골절의 가장 흔한 형태 중 하나이며, 대부분의 척추 압박골절은 궁극적으로 무증상 혹은 최소한의 잔여 증상을 남기게 되지만, 많은 수에서 상당한 통증을 느끼면서 일상생활의 저해와 장애를 겪게 된다. 특히, 척추 압박골절 환자에서 골절 부위의 속발성 혹은 진행성 재골절은 가장 주의해야 할 합병증이지만, 발병률에 대한 정확한 문헌 보고는 없는 실정이다. 이에 본 저자들은 보행자 교통사고로 인한 낙상에 준하는 충격에 의해 발생한 골다공증성 척추 압박골절 환자에서 보존적 치료를 시행한 후 18개월이 지난 시점에서 속발성 재골절이 발견되어 뒤늦게 수술적 치료를 받은 77세 남자 환자 1예를 보고하면서 척추 압박골절 환자에서 보존적 치료 혹은 척추성형술과 같은 최소 침습적 중재 시술을 한 후 1년간의 주기적인 임상 경과 및 방사선학적 경과 관찰의 중요성을 강조하고자 하였다.

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