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Indirect Decompression of Osteoporotic Vertebral Compression Fracture Using Intraoperative Motor Evoked Potential Monitoring-Guided Ligamentotaxis

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Author(s)
Subin KweonSaemin KwonChanghyun KimChangyoung LeeInsoo KimYoung San Ko
Keimyung Author(s)
Kwon, Sae MinKim, Chang HyunLee, Chang YoungKim, In SooKo, Young San
Department
Dept. of Neurosurgery (신경외과학)
Journal Title
Korean J Neurotrauma
Issued Date
2023
Volume
19
Issue
2
Keyword
Anabolic agentAnterior longitudinal ligamentCompression fractureEvoked potential, motorFracture reductionOsteoporotic fracturesPosterior longitudinal ligament
Abstract
Osteoporotic vertebral compression fractures have become common in aging societies and can lead to a decreased quality of life with severe back pain and neurological deficits. Traditional direct decompression and stabilization surgeries can produce sufficient decompression and provide good results. However, after surgical treatment, some elderly patients with numerous chronic diseases often experience severe postoperative complications owing to the long surgery duration and massive bleeding. Therefore, to prevent perioperative morbidity, other surgical methods that simplify the surgical process and reduce the operation time are required. Herein, we describe a case of indirect decompression using ligamentotaxis and sequential anabolic agents. To examine their effectiveness during surgery, we monitored intraoperative motor-evoked potentials. The patient's neurological symptoms improved postoperatively. After the operation, the anabolic agent "romosozumab" was injected monthly to treat osteoporosis, prevent additional fractures, and accelerate posterolateral fusion. On serial follow-up, the anterior body height of the fractured vertebra improved significantly, demonstrating the importance of osteoporosis treatment using anabolic agents. Indirect decompression surgery may have early effects, whereas sequential anabolic agent use may consolidate the long-term effects of surgical treatment.
Keimyung Author(s)(Kor)
권세민
김창현
이창영
김인수
고용산
Publisher
School of Medicine (의과대학)
Type
Article
ISSN
2288-2243
Source
https://kjnt.org/DOIx.php?id=10.13004/kjnt.2023.19.e21
DOI
10.13004/kjnt.2023.19.e21
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/45274
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학)
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