Delayed Subsequent Refracture of a Thoracolumbar Vertebral Compression Fracture

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.