title: Osteoporotic vertebral fracture adjacent to a nonsegmented hemivertebra.
abstract: A combination of osteoporotic vertebral fractures and congenital spinal deformity is theoretically possible, but there have been no reports on this combination in the literature. We describe a rare case of an osteoporotic vertebral fracture adjacent to the nonsegmented hemivertebra. A 60-year-old postmenopausal woman who did not recall any specific trauma presented with severe back pain. She had markedly decreased bone mineral density and significant lumbar kyphoscoliosis with a nonsegmented hemivertebra between L1 and L2 on radiographs of the lumbar spine. Magnetic resonance imaging (MRI) revealed a vertebral fracture adjacent to the nonsegmented hemivertebra. Laboratory studies showed increased serum bone-specific alkaline phosphatase (BAP) and urinary type I collagen crosslinked N-telopeptide (NTx). A thoracolumbar brace was applied for 3 months. Daily administration of alendronate normalized her serum BAP and urinary NTx levels. MRI scans of the lumbar spine after 6 months also confirmed normalized signal intensities of the fractured vertebra adjacent to the nonsegmented hemivertebra. The vertebral fracture seemed to be induced by spinal malalignment, increased stress on the adjacent level of the fused segment, and its fragility due to osteoporosis.
authors.affiliation: Department of Orthopedic Surgery, Akita University School of Medicine, 1-1-1 Hondo, Akita, 010-8543 Japan.
authors.forename: Naohisa
authors.initials: N
authors.lastname: Miyakoshi
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Shimada
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Suzuki
authors.forename: Michio
authors.initials: M
authors.lastname: Hongo
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kasukawa
authors.forename: Kyoji
authors.initials: K
authors.lastname: Okada
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kodama
authors.forename: Eiji
authors.initials: E
authors.lastname: Itoi
mesh_terms: D017760:Bone Malalignment / Q000150:complications; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000002:abnormalities*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications; D016103:Spinal Fractures / Q000150:complications* / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D013314:Stress, Mechanical; D014057:Tomography, X-Ray Computed