PDF herunterladen
CC-BY 4.0 · Surg J (N Y) 2017; 03(01): e48-e52
DOI: 10.1055/s-0037-1601321
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Occipitosacral Fusion for Multiple Vertebral Fractures with Kyphotic Deformity in a Patient with Mutilating Rheumatoid Arthritis: A Case Report

Tetsu Tanouchi
1   Department of Orthopedic Surgery, Gunma Spine Center, Harunaso Hospital, Takasaki, Gunma, Japan
,
Takachika Shimizu
1   Department of Orthopedic Surgery, Gunma Spine Center, Harunaso Hospital, Takasaki, Gunma, Japan
,
Masatake Ino
1   Department of Orthopedic Surgery, Gunma Spine Center, Harunaso Hospital, Takasaki, Gunma, Japan
,
Naofumi Toda
1   Department of Orthopedic Surgery, Gunma Spine Center, Harunaso Hospital, Takasaki, Gunma, Japan
,
Nodoka Manabe
1   Department of Orthopedic Surgery, Gunma Spine Center, Harunaso Hospital, Takasaki, Gunma, Japan
,
Kanako Itoh
1   Department of Orthopedic Surgery, Gunma Spine Center, Harunaso Hospital, Takasaki, Gunma, Japan
,
Keisuke Fueki
1   Department of Orthopedic Surgery, Gunma Spine Center, Harunaso Hospital, Takasaki, Gunma, Japan
› Institutsangaben
Weitere Informationen

Publikationsverlauf

06. November 2016

15. Februar 2017

Publikationsdatum:
20. März 2017 (online)

Auch verfügbar auf
   Lizenzen und Reprints

Abstract

Osteoporotic vertebral fractures are well-known complications of rheumatoid arthritis. The management of multiple vertebral fractures with kyphotic deformity is controversial. We present a case of a patient with mutilating rheumatoid arthritis who had multiple vertebral fractures with kyphotic deformity after occipitothoracic fusion for rheumatoid cervical disorder. Occipitosacral fusion was effective to create stable spine with better sagittal alignment in this case, but careful clinical assessment for early detection and management of postoperative insufficient pelvic fracture were required.

Keywords

Kyphosis - osteoporosis - rheumatoid arthritis - thoracolumbar spine - vertebral compression fracture
 

  • References

  • 1 Hooyman JR, Melton III LJ, Nelson AM, O'Fallon WM, Riggs BL. Fractures after rheumatoid arthritis. A population-based study. Arthritis Rheum 1984; 27 (12) 1353-1361
    CrossrefPubMedSuche in Google Scholar
  • 2 Furuya T, Kotake S, Inoue E. , et al. Risk factors associated with incident clinical vertebral and nonvertebral fractures in Japanese women with rheumatoid arthritis: a prospective 54-month observational study. J Rheumatol 2007; 34 (02) 303-310
    PubMedSuche in Google Scholar
  • 3 Mohammad A, Lohan D, Bergin D. , et al. The prevalence of vertebral fracture on vertebral fracture assessment imaging in a large cohort of patients with rheumatoid arthritis. Rheumatology (Oxford) 2014; 53 (05) 821-827
    CrossrefPubMedSuche in Google Scholar
  • 4 Ishida O, Furuya T, Inoue E. , et al. Risk factors for established vertebral fractures in Japanese patients with rheumatoid arthritis: results from a large prospective observational cohort study. Mod Rheumatol 2015; 25 (03) 373-378
    CrossrefPubMedSuche in Google Scholar
  • 5 Kvien TK, Haugeberg G, Uhlig T. , et al. Data driven attempt to create a clinical algorithm for identification of women with rheumatoid arthritis at high risk of osteoporosis. Ann Rheum Dis 2000; 59 (10) 805-811
    CrossrefPubMedSuche in Google Scholar
  • 6 Lodder MC, de Jong Z, Kostense PJ. , et al. Bone mineral density in patients with rheumatoid arthritis: relation between disease severity and low bone mineral density. Ann Rheum Dis 2004; 63 (12) 1576-1580
    CrossrefPubMedSuche in Google Scholar
  • 7 Cho S-K, Lee J-H, Han M. , et al. The influence of vertebral fracture on the functional disability of patients with rheumatoid arthritis. J Korean Med Sci 2014; 29 (06) 859-863
    CrossrefPubMedSuche in Google Scholar
  • 8 Omata Y, Hagiwara F, Nishino J. , et al. Vertebral fractures affect functional status in postmenopausal rheumatoid arthritis patients. J Bone Miner Metab 2014; 32 (06) 725-731
    CrossrefPubMedSuche in Google Scholar
  • 9 Kado DM, Duong T, Stone KL. , et al. Incident vertebral fractures and mortality in older women: a prospective study. Osteoporos Int 2003; 14 (07) 589-594
    CrossrefPubMedSuche in Google Scholar
  • 10 Pongchaiyakul C, Nguyen ND, Jones G, Center JR, Eisman JA, Nguyen TV. Asymptomatic vertebral deformity as a major risk factor for subsequent fractures and mortality: a long-term prospective study. J Bone Miner Res 2005; 20 (08) 1349-1355
    CrossrefPubMedSuche in Google Scholar
  • 11 Tanouchi T, Shimizu T, Fueki K. , et al. Neurological improvement and prognosis after occipito-thoracic fusion in patients with mutilating-type rheumatoid arthritis. Eur Spine J 2012; 21 (12) 2506-2511
    CrossrefPubMedSuche in Google Scholar
  • 12 Tanouchi T, Shimizu T, Fueki K, Ino M, Toda N, Manabe N. Adjacent-level failures after occipito-thoracic fusion for rheumatoid cervical disorders. Eur Spine J 2014; 23 (03) 635-640
    CrossrefPubMedSuche in Google Scholar
  • 13 Suh S-P, Kim C-W, Jo Y-H, Kang C-N. Height restoration after balloon kyphoplasty in rheumatoid patients with osteoporotic vertebral compression fracture. Asian Spine J 2015; 9 (04) 581-586
    CrossrefPubMedSuche in Google Scholar
  • 14 Lee S-H, Kang YM, Park Y-M. Multiple vertebral involvement of rheumatoid arthritis in thoracolumbar spine: a case report. J Korean Med Sci 2010; 25 (03) 472-475
    CrossrefPubMedSuche in Google Scholar
  • 15 Nakase T, Fujiwara K, Kohno J. , et al. Pathological fracture of a lumbar vertebra caused by rheumatoid arthritis--a case report. Int Orthop 1998; 22 (06) 397-399
    CrossrefPubMedSuche in Google Scholar
  • 16 Ozaki D, Shirai Y, Nakayama Y, Uesaka S. A case report of insufficiency fracture of the Fossa acetabuli in a patient with rheumatoid arthritis. J Nippon Med Sch 2000; 67 (04) 267-270
    CrossrefPubMedSuche in Google Scholar
  • 17 Hoshino Y, Doita M, Yoshikawa M, Hirayama K, Sha N, Kurosaka M. Unstable pelvic insufficiency fracture in a patient with rheumatoid arthritis. Rheumatol Int 2004; 24 (01) 46-49
    CrossrefPubMedSuche in Google Scholar
  • 18 Fukunishi S, Fukui T, Nishio S, Imamura F, Yoshiya S. Multiple pelvic insufficiency fractures in rheumatoid patients with mutilating changes. Orthop Rev (Pavia) 2009; 1 (02) e23
    PubMedSuche in Google Scholar