J Korean Neurosurg Soc.  2015 Jan;57(1):32-35. 10.3340/jkns.2015.57.1.32.

Clinical Analysis of Acute Radiculopathy after Osteoporotic Lumbar Compression Fracture

• Kim DE
• Kim HS
• Kim SW
• Kim HS

• KMID: 2067088
• DOI: http://doi.org/10.3340/jkns.2015.57.1.32

Abstract

OBJECTIVE
The purpose of this study was to analyze the relationship between fracture pattern and the development of acute radiculopathy after osteoporotic lumbar compression fracture.
METHODS
This study included 59 patients who underwent bone cement augmentation for osteoporotic compression fracture below the L2 level, which can lead to radiculopathic radiating pain. The patients were divided into two groups according to the presence of radiculopathy (group A : back pain only; group B : back pain with newly developed radiating pain). We categorized compression fractures into three types by the position of the fracture line. The incidence of newly developed radiculopathy was examined retrospectively for each compression fracture type.
RESULTS
The overall incidence of newly developed leg pain (group B) was 25%, and the frequency increased with descending spinal levels (L2 : 0%, L3 : 22%, L4 : 43%, and L5 : 63%). The back pain-only group (group A) had mostly superior-type fractures. On the other hand, the back pain with radiculopathy group (group B) had mostly inferior-type fractures. Most patients in group B showed significant relief of leg pain as well as back pain after bone cement augmentation.
CONCLUSION
The incidence of a newly developed, radiating pain after osteoporotic compression fractures increased gradually from the L3 to L5 levels. Most of these fractures were of the inferior type, and the bone cement augmentation procedures seemed to be sufficient for relief of both back and radiating pain.

Keyword

Fracture; Osteoporosis; Radiculopathy

MeSH Terms

Back Pain
Fractures, Compression*
Hand
Humans
Incidence
Leg
Osteoporosis
Radiculopathy*
Retrospective Studies

Figure

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  Fig. 1 Three fracture types according to the main position of the fracture line. A and B : Superior type. C and D : Middle type. E and F : Inferior type.

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  Fig. 2 The intergroup difference in fracture pattern.

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  Fig. 3 The improvement in pain score. VAS : visual analogue scale, OP : operation, F/U : follow-up.

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  Fig. 4 A 67-year-old woman with back pain and left leg radiating pain (inferior fracture type). A and B : T1-weighted sagittal and fat-suppression images showing osteoporotic compression fracture at L3, and root compression at the intervertebral foramen. C : Simple radiographic image obtained after the vertebroplasty at L3.

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  Fig. 5 A-69-year-old woman with back pain and right leg radiating pain (superior fracture type). A and B : T2-weighted and fat-suppression images showing osteoporotic compression fracture at L5 and stenosis at levels L4 and L5 (arrow). C : Simple radiographic image obtained after the vertebroplasty at L5.

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