Multiple Lumbar Compression Fractures due to Hypopituitarism as a Late Complication of Hemorrhagic Fever with Renal Syndrome: A case report

Male osteoporosis is known to progress slowly and is less severe compared to female osteoporosis, and the incidence of lumbar compression fracture is considerably lower in male population. Hypogonadism which can develop from various causes including hypopituitarism is a common cause for secondary male osteoporosis. Hypopituitarism as a late complication of severe form of hemorrhagic fever with renal syndrome (HFRS) is known to occur occasionally but its clinical symptoms rarely appear. A 75-year-old male patient who had recovered from HFRS 13 years ago was admitted due to severe low back pain. He presented with gradually developed symptoms of hypogonadism and hypothyroidism resulting from hypopituitarism. MRI revealed collapsed pituitary gland and empty sella. This case presents with a male patient with multiple lumbar compression fractures due to severe osteoporosis secondary to hypogonadism, which resulted from hypopituitarism as a late complication of HFRS.

Effect of Spinal Decompression Therapy Compared with Intermittent Mechanical Traction in Lumbosacral Disc Herniation

OBJECTIVE: To compare the effects of intermittent mechanical traction with spinal decompression therapy (SDT), using the newly introduced device DRX 3000(R), in patients suffering from low back pain associated with lumbosacral disc herniation documented on MRI. METHOD: Thirty-five patients with low back pain with or without lower extremity radiating pain were prospectively enrolled in this study. They were all diagnosed with lumbosacral disc herniation according to physical examinations and MRI. Patients over age 60 years or those with previous spinal surgery, spondylolisthesis, severe osteoporosis, rheumatic diseases, hypertension, and other serious medical problems were excluded. Patients were randomly assigned to intermittent mechanical traction group (15 patients) or SDT group (20 patients) and compared visual analog pain scale (VAS) pre- and post-treatment. RESULTS: There was a significant improvement in VAS in SDT group compared to intermittent mechanical traction group. The mean reduction in VAS for intermittent mechanical traction group equaled 1.93+/-0.83 (from 6.4+/-1.28 to 4.5+/-1.22) while the mean reduction in VAS in SDT group equaled 4.35+/-2.21 (from 6.9+/-1.86 to 2.6+/-1.43) (p=0.0006). CONCLUSION: Spinal decompression therapy can be used as an effective treatment for discogenic low back pain without serious complications.