title: Double-level posterior spinal shortening for paralytic osteoporotic vertebral collapse of two vertebral bodies with a normal vertebra in between: a case report.
abstract: BACKGROUND
  Spinal shortening is indicated for osteoporotic vertebral collapse. However, this surgical procedure has not been indicated for more than two vertebral levels that are not adjacent. We experienced a rare case of paraparesis due to osteoporotic vertebral collapse of two vertebral bodies with a normal vertebra in between and treated successfully by the double-level posterior shortening procedure.
  
  
  METHODS
  A 79-year-old woman suffered from delayed paraparesis 2 years after L1 and Th11 vertebral body compression fracture. Plain X-ray photographs showed Th11 and L1 vertebral body collapse, Th7 compression fracture and a kyphosis angle of 30 degrees from Th10 to L2. Plain magnetic resonance imaging showed spinal canal stenosis at Th11 and L1 vertebral body levels. She was treated by double-level posterior spinal shortening using pedicle screw and hook systems.
  
  
  RESULTS
  After the procedure, the patient's kyphosis angle decreased to 10 degrees and her back pain, leg pain, and sensory deficits improved. She was able to walk by herself. Although new vertebral compression fractures occurred at L4 and L5 in the follow-up period, there has been no deterioration of the neurological symptoms 5 years after the operation.
  
  
  CONCLUSIONS
  Delayed paraparesis after double-level thoracolumbar vertebral collapse due to osteoporosis was treated successfully by double-level posterior spinal shortening using a pedicle screw and hook system.
authors.affiliation: Department of Orthopaedic Surgery, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan.
authors.forename: Kenta
authors.initials: K
authors.lastname: Kikuike
authors.forename: Kei
authors.initials: K
authors.lastname: Miyamoto
authors.forename: Hideo
authors.initials: H
authors.lastname: Hosoe
authors.forename: Yasuhito
authors.initials: Y
authors.lastname: Kushima
authors.forename: Katsuji
authors.initials: K
authors.lastname: Shimizu
mesh_terms: D000368:Aged; D005260:Female; D050815:Fractures, Compression / Q000150:complications / Q000601:surgery*; D006801:Humans; D008159:Lumbar Vertebrae / Q000293:injuries*; D019637:Orthopedic Procedures / Q000379:methods*; D015663:Osteoporosis, Postmenopausal / Q000150:complications; D020335:Paraparesis / Q000209:etiology*; D016103:Spinal Fractures / Q000150:complications / Q000601:surgery*; D013130:Spinal Stenosis / Q000150:complications; D013904:Thoracic Vertebrae / Q000293:injuries*