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A Sudden Change in Vertebroplasty Candidacy in an Elderly Man with Lumbar Compression Fractures: A Cautionary Case
Yashesh Parekh1, Moorice Caparo1
1Department of Physical Medicine and Rehabilitation, Montefiore Medical Center, Bronx, NY.
Background:
Osteoporosis is the leading cause of vertebral fractures, often requiring multimodal and interventional pain management, in elderly adults. Selection of vertebroplasty candidates, timing, and evaluation for risk factors is crucial for optimal results.
Case Report:
A 73-year-old man with acute on chronic lower back pain with radicular symptoms, was found to have osteoporotic lumbar vertebral compression fractures with anterior and posterior column involvement. Initially an optimal vertebroplasty candidate, after re-evaluation with a computed tomography scan, showed significant displacement. Given the patient's radicular pain, he was successfully treated with transforaminal epidural steroid injections.
Conclusion:
The selection of vertebroplasty candidates is a delicate process to prevent complications. This case opens the discussion for the need to further study the profiling and monitoring of patients for potential changes in candidacy, a current gray area.
