J Korean Soc Spine Surg.  2019 Mar;26(1):21-25. 10.4184/jkss.2019.26.1.21.

Unilateral Biportal Endoscopy as a Treatment for Acute Radiculopathy after Osteoporotic Lumbar Compression Fracture: A Case Report

• Kim HB
• Chung HJ

• KMID: 2442344
• DOI: http://doi.org/10.4184/jkss.2019.26.1.21

Abstract

STUDY DESIGN: Case report.
OBJECTIVES
To document unilateral biportal endoscopy (UBE) as a treatment for acute radiculopathy after osteoporotic vertebral fracture. SUMMARY OF LITERATURE REVIEW: Acute radiculopathy after osteoporotic vertebral fracture leads to claudication. Treatment of osteoporotic vertebral fractures with accompanying radiating pain is challenging.
MATERIALS AND METHODS
A 74-year-old woman was diagnosed with an osteoporotic vertebral fracture at L3 after slipping and falling. Vertebroplasty was performed for the osteoporotic vertebral fracture at L3. She still complained of right lower extremity radiating pain. UBE was performed to treat acute radiculopathy.
RESULTS
Foraminal decompression using UBE was performed at the L3-4 right foraminal area. Her symptoms resolved after surgery.
CONCLUSIONS
UBE is a useful treatment method for acute radiculopathy after osteoporotic vertebral fracture.

Keyword

Unilateral biportal endoscopy; Osteoporotic vertebral fracture

MeSH Terms

Accidental Falls
Aged
Decompression
Endoscopy*
Female
Fractures, Compression*
Humans
Lower Extremity
Methods
Radiculopathy*
Vertebroplasty

Figure

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  Fig. 1. An X-ray showing degenerative scoliosis and compression defor-mity at L3.

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  Fig. 2. Magnetic resonance imaging (MRI) findings. (A) MRI shows an acute compression fracture at L3 with a fracture line (arrow) in the infe-rior part (1/3) of the vertebral body. (B) A fracture fragment extending to the spinal canal was noted. (C) Severe foraminal stenosis was noted at the L3-4 right foraminal area (arrow head).

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  Fig. 4. Unilateral biportal endoscopy was performed. (A) Three-dimensional computed tomography scan for preoperative planning, showing the L3-4 right foraminal area (arrow). (B) The endoscopic view of the foraminal area was the same as in the 3-dimensional image, with this view of the superior articular process of L4 (∗). (C) Bony decompression was done. (D) Full decompression was seen at the foraminal area.

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  Fig. 3. The patient underwent percutaneous vertebroplasty at L3.

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  Fig. 5. Comparison of magnetic resonance imaging findings between the preoperative (A) and postoperative (B) foraminal area.

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