Vertebral fracture and spinal cord compression after removal of pedicle screws in PD patients: case report and literature review
Abstract
Introduction: Pedicle screws are used in spinal surgery and have yielded favorable postoperative outcomes. Despite this, the optimal timing for their removal remains controversial. This study presents a case report of a patient with Parkinson's disease who experienced rapid vertebral fracture and spinal cord compression after pedicle screw removal. We outlined the patient's management, and follow up and discuss consideration for screw removal.
Case presentation: A 58-year-old woman with an 8-year history of Parkinson's disease underwent lumbar surgery (L4-L5 oblique lumbar interbody fusion, L5-S1 transverse lumbar interbody fusion, and T12-L4 posterolateral lumbar fusion), including pedicle screw implantation at a local hospital 3 years prior for degenerative lumbar spondylolisthesis and lumbar spinal stenosis. She presented with lower back pain and bilateral lower limb numbness for 7 months. The patient was diagnosed with failed back surgery syndrome and underwent posterior fixation removal, interbody fusion cage removal, decompression, fusion with bone grafting, and new internal fixation (L4-S2). However, 3 months postoperatively, the lower back pain recurred and worsened by the fourth month, accompanied by lower limb weakness. Subsequently, the patient was diagnosed with L2 and L3 vertebral fractures and spinal cord injury.
Results: With appropriate treatment including total L2 laminectomy with decompression, intertransverse bone grafting, L2 vertebroplasty, pedicle…
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- Effectiveness of Bisphosphonates and Denosumab on Risk of Vertebral Fractures in Prostate Cancer Patients Under Androgen Deprivation Therapies: A Real-World Prospective Study
- Osteoporosis-related fractures after spinal cord injury: a retrospective study from Brazil
- Serum 25-hydroxyvitamin D, parathyroid hormone, and mortality in older men
- Lack of Association between Vitamin D Insufficiency and Cardiovascular or Fracture Risk: A UK Biobank Study
- Muscle strength and body composition are clinical indicators of osteoporosis
- Incidence of bone protection and associated fragility injuries in patients with proximal femur fractures
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.