Vertebral fracture at the caudal end of diffuse idiopathic skeletal hyperostosis treated with vertebroplasty via double-endplate penetrating screw trajectory and posterior spinal fixation with a new hybrid strategy using cement-augmented fenestrated pedicle screws

Author:

Hashiba Daisuke1,Fujimoto Kazuki1ORCID,Nakagawa Ryosuke1,Maeyama Toshifumi1,Arai Hajime1,Ohtori Seiji2

Affiliation:

1. Department of Orthopaedic Surgery, Kohnodai Hospital, National Center for Global Health and Medicine , 1-7-1 Kohnodai, Ichikawa city, Chiba 272-8516 , Japan

2. Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University , 1-8 Inohana, Chuo-ku, Chiba city, Chiba 260-0856 , Japan

Abstract

Abstract Vertebral fractures in diffuse idiopathic skeletal hyperostosis (DISH) are often unstable. We encountered a case of vertebral fracture at the caudal end of DISH in which vertebroplasty was performed via a double endplate penetrating screw (DEPS) trajectory, and short posterior fixation was performed using the DEPS technique on the cranial vertebrae, including the fractured vertebra; conventional pedicle screw to the caudal vertebrae; and cement-augmented fenestrated pedicle screws to the caudal end vertebra. A 93-year-old man presented with a vertebral fracture at the caudal end of a DISH after a fall. He underwent surgery for lower back pain due to spinal instability. Vertebroplasty via DEPS trajectory can shorten the posterior fixation range. Using cement-augmented fenestrated pedicle screws to the caudal end vertebra enables balancing of the posterior fixation force. This strategy should be considered when a vertebral fracture is found at the caudal end of the DISH.

Funder

National Center for Global Health and Medicine

Publisher

Oxford University Press (OUP)

Subject

Surgery

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