title: Kyphoplasty for Intractable Pain Due to Glucocorticosteroid-induced Osteoporotic Vertebra Fracture of a 9-Year-Old Patient With Systemic Lupus Erythematosus: 8-Year Follow-up.
abstract: BACKGROUND
  The incidence of glucocorticoid-induced osteoporosis is approximately 50% in patients treated for >6 months, and in the long-term usage fracture risk is approximately 34%. The awareness of pediatric vertebral fractures due to glucocorticoid-induced osteoporosis is increasing. Although most of these fractures are asymptomatic, a small number of children may have severe pain.
  
  
  OBJECTIVE
  In this case report we are presenting long-term result of a 9-year-old patient with intractable pain due to glucocorticoid-induced osteoporotic vertebral fracture managed by kyphoplasty.
  
  
  METHODS
  Case report.
  
  
  METHODS
  Case report of a 9-year-old girl who had L3 vertebral fracture due to glucocorticoid-induced osteoporosis treated by kyphoplasty.
  
  
  METHODS
  The patient was a 9-year-old girl with severe back pain, and lupus nephritis. Glucocorticoid-induced L3 vertebral fracture was detected and the case was resistant to conservative treatment. Seeing this, we have performed balloon kyphoplasty procedure to L3 vertebrae.
  
  
  RESULTS
  No complication and pain was observed after the operation although L3 vertebral height could not restored. On the 8-year control, L3 vertebral height was almost totally restored with a compression index of 10% without any clinical problem.
  
  
  CONCLUSIONS
  To the best of the authors' knowledge, the patient sample of this case report is the first and the youngest patient who was treated with kyphoplasty for vertebral compression fracture intractable pain due to glucocorticoid-induced osteoporosis, mentioned in literature. During the 8-year follow-up, no adverse effect was reported that was related to kyphoplasty procedure. This case report indicates that kyphoplasty can be an alternative method for selective pediatric intractable painful vertebral glucocorticoid-induced osteoporotic fractures, but it should be performed after careful consideration in pediatric group. We do not advise routine usage of kyphoplasty for pediatric vertebral fractures.
authors.affiliation: Department of Orthopedics and Traumatology, Gazi University Hospital, Ankara, Turkey.
authors.forename: Ulunay
authors.initials: U
authors.lastname: Kanatli
authors.forename: Baybars
authors.initials: B
authors.lastname: Ataoğlu
authors.forename: Mustafa
authors.initials: M
authors.lastname: Özer
authors.forename: Alpaslan
authors.initials: A
authors.lastname: Şenköylü
authors.forename: Mehmet
authors.initials: M
authors.lastname: Çetinkaya
mesh_terms: D001416:Back Pain / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D050815:Fractures, Compression / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D058498:Kyphoplasty / Q000379:methods*; D008159:Lumbar Vertebrae / Q000293:injuries*; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy; D010024:Osteoporosis / Q000139:chemically induced / Q000150:complications; D058866:Osteoporotic Fractures / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D059408:Pain Management; D010148:Intractable Pain / Q000209:etiology / Q000628:therapy; D011859:Radiography; D016103:Spinal Fractures / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids