Abstract
A 78-year-old female with a history of osteoporosis presents for evaluation of sudden mid back pain. She was in her usual state of good health when she tripped and fell 6 weeks ago. The fall caused sudden pain and she has since been in a Jewett brace. While her pain is improved slightly, she is still restricted and has pain with activities. The pain is described as a sharp pain in her mid back. The pain is provoked with activity or any changing of positions. Her pain is worsened with prolonged standing and is improved by lying down. Narcotic analgesics help, but she has constipation from taking the medications. Radiographs (Fig. 20.1a, b) and magnetic resonance imaging (MRI) (Fig. 20.2) show a compression fracture at L2.
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