Abstract
Introduction Radiofrequency-targeted vertebral augmentation (RF-TVA) is a recognized treatment for painful compression fractures. RF-TVA in a patient with multiple compression fractures due to type I osteogenesis imperfecta (OI) has not been previously reported. Case Presentation A 54-year-old patient with type I OI is presented with a segmental thoracic hyperkyphosis and 7 recent vertebral compression fractures. Because of persistent severe thoracolumbar back pain despite conservative therapy, RF-TVA was indicated. Nocturnal back pain was almost completely relieved at all postoperative time points evaluated. However, overall pain relief dropped only slightly from 7 to 5 on the numerical rating scale (NRS) at the 6-week follow-up, and there was only a small decrease in the Oswestry Disability Index (ODI) from 72% to 63%. An MRI at the 3-month follow-up revealed hyperintensity at levels T11 and T12, indicating slight recollapsing. At the 6-month follow-up, the ODI improved to 55%, although overall pain had worsened to 6 on the NRS. Pain at rest remained at a very low level. Conclusion Despite the remaining lumbago, RF-TVA may be a good option for patients with OI who have multiple fractures. However, fractures at multiple levels and segmental thoracic hyperkyphosis may increase the risk for recollapsing and ongoing pain.
Highlights
Radiofrequency-targeted vertebral augmentation (RF-TVA) is a recognized treatment for painful compression fractures
A 54-year-old patient with type I osteogenesis imperfecta (OI) is presented with a segmental thoracic hyperkyphosis and 7 recent vertebral compression fractures
At the 6-month follow-up, the Oswestry Disability Index (ODI) improved to 55%, overall pain had worsened to 6 on the numerical rating scale (NRS)
Summary
Vertebral compression factures are common and painful in patients with osteoporosis and osteogenesis imperfecta (OI). Conservative treatment frequently provides only short-term pain relief [1, 2], in which case balloon kyphoplasty is a common procedure when surgery is indicated. Radiofrequency-targeted vertebral augmentation (RF-TVA), developed from the balloon kyphoplasty procedure, is a recent augmentation method that uses high-viscosity cement [3, 4]. We extended the indication of RF-TVA to a 54-yearold woman with multiple compression fractures of Th8–12, L1, and L3, along with diminished osseous stability owing to type I osteogenesis imperfecta and osteoporosis. To our knowledge, this is the first case report describing treatment of a multilevel-fractured spine with RF-TVA
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