Abstract
Osteoporotic thoracolumbar burst fractures are rarely complicated by neurological deficits. Recently the treatment of these fractures has been controversial. A 69-year-old woman developed paraparesis in June 1991 with no previous history of trauma. Radiograph demonstrated a burst fracture of the 11th thoracic vertebra and myelography disclosed incomplete blockage of contrast column at this level. The CT scan demonstrated retropulsion of vertbral fragment into the spinal canal. The patient had a past medical history of chronic viral hepatitis type C. If the patient's general condition permited, anterior decompression and stabilization seemed to be the most reasonable treatment at that time. However, we had to chose a minor invasive surgery because of the complications. We planned and carried out a modified decompression surgery without spinal instrumentation. Two years and five months after the surgery she recovered from Frankel grade C to D despite her kyphosis not being corrected nor stabilized. The kyphosis was assessed using the Cobb method on the lateral radiograph. Her preoperative kyphotic angulation was 16° and progressed to 21° at the time of the follow-up. Anterior decompression is an essential factor for neurological recovery, however, in exceptional cases stabilization is omissible.
