Skip to main content
Log in

Pregnancy-associated osteoporosis with eight fractures in the vertebral column treated with kyphoplasty and bracing: a case report

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Pregnancy-associated osteoporosis is a rare condition, which imposes multiple symptoms in the musculoskeletal system. Common complaints announced by patients are severe pain in the lower back, hips and the joints of the lower extremities with a reduced and less mobility status in general. Most of the patients’ problems occur in the last trimester of pregnancy or postpartum and are often not diagnosed as side effects of osteoporosis but as problems associated with pregnancy. Although vertebral fractures are rare complications of pregnancy-associated osteoporosis, they should be always considered in women presenting with an acute pain syndrome in peripregnancy period. This case presents a 40-year-old primagravid woman who developed pain in hips and severe pain in the lower back causing an immobilization diagnosed with a pregnancy-associated osteoporosis with eight compression fractures in the thoracic and lumbar spine. Because of sagittal imbalance of the spine, she was treated with kyphoplasty at the four lumbar fractures and with bracing for the upper, thoracic ones, additional to the conservative anti-osteoporotic therapy. The authors discuss pregnancy-associated osteoporosis and its clinical presentation, as well as the indications of kyphoplasty, spinal alignment and the risk of single conservative treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

References

  1. Khovidhunkit W, Epstein S (1996) Osteoporosis in pregnancy. Osteoporos Int 6(5):345–354

    Article  CAS  PubMed  Google Scholar 

  2. Mahadevan S, Kumaravel V, Bharath R (2012) Calcium and bone disorders in pregnancy. Indian J Endocrinol Metab 16(3):358–363

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  3. Di Gregorio S et al (2000) Osteoporosis with vertebral fractures associated with pregnancy and lactation. Nutrition 16(11–12):1052–1055

    Article  PubMed  Google Scholar 

  4. Wisser J et al (2005) Changes in bone density and metabolism in pregnancy. Acta Obstet Gynecol Scand 84(4):349–354

    PubMed  Google Scholar 

  5. Dunne F et al (1993) Pregnancy associated osteoporosis. Clin Endocrinol (Oxf) 39(4):487–490

    Article  CAS  Google Scholar 

  6. Peris P et al (2002) Pregnancy associated osteoporosis: the familial effect. Clin Exp Rheumatol 20(5):697–700

    CAS  PubMed  Google Scholar 

  7. Heim U et al (2010) Schwangerschafts-assozierte Osteoporose. Der Orthopäde 09/2010. Springer, pp 1051–1056

  8. Graziotti PJ, Graziotti CR, Sangster AM (2013) Significance of preoperative MRI in establishing levels of augmentation for percutaneous vertebroplasty. J Pain Res 6:359–365

    Article  PubMed Central  PubMed  Google Scholar 

  9. O’Sullivan SM et al (2006) Bisphosphonates in pregnancy and lactation-associated osteoporosis. Osteoporos Int 17(7):1008–1012

    Article  PubMed  Google Scholar 

  10. Ofluoglu O, Ofluoglu D (2008) A case report: pregnancy-induced severe osteoporosis with eight vertebral fractures. Rheumatol Int 29(2):197–201

    Article  PubMed  Google Scholar 

  11. Bayram S et al (2006) Kyphoplasty for pregnancy-associated osteoporotic vertebral fractures. Joint Bone Spine 73(5):564–566

    Article  PubMed  Google Scholar 

  12. Silverman SL (1992) The clinical consequences of vertebral compression fracture. Bone 13(Suppl 2):S27–S31

    Article  PubMed  Google Scholar 

  13. Kim HW et al (2010) Percutaneous vertebroplasty for pregnancy-associated osteoporotic vertebral compression fractures. J Korean Neurosurg Soc 47(5):399–402

    Article  PubMed Central  PubMed  Google Scholar 

  14. Vujasinovic-Stupar N et al (2012) Pregnancy-associated spinal osteoporosis treated with bisphosphonates: long-term follow-up of maternal and infants outcome. Rheumatol Int 32(3):819–823

    Article  PubMed  Google Scholar 

  15. Donovan MA, Khandji AG, Siris E (2004) Multiple adjacent vertebral fractures after kyphoplasty in a patient with steroid-induced osteoporosis. J Bone Miner Res 19(5):712–713

    Article  PubMed  Google Scholar 

  16. Gui XG et al (2013) Analysis of perioperative complications of percutaneous kyphoplasty for osteoporotic vertebral compression fracture. Zhongguo Gu Shang 26(3):205–209

    PubMed  Google Scholar 

  17. Ferraris L (2012) Die Bedeutung der sagittalen Balance in der Wirbelsäulenchirurgie (The relevance of the sagittal balance in spine surgery). In: OUP; Koller H (eds) Deutscher Ärzte Verlag, Werner-Wicker-Klinik, Bad Wildungen, pp 502–508

  18. Chaléat-Valayer E et al (2011) Sagittal spino-pelvic alignment in chronic low back pain. Eur Spine J 20(Suppl 5):634–640

    Article  PubMed Central  PubMed  Google Scholar 

  19. Faundez A, Roussouly P, Le Huec JC (2011) Sagittal balance of the spine: a therapeutic revolution. Rev Med Suisse 7(322):2470–2474

    CAS  PubMed  Google Scholar 

  20. Koller H et al (2008) Long-term investigation of nonsurgical treatment for thoracolumbar and lumbar burst fractures: an outcome analysis in sight of spinopelvic balance. Eur Spine J 17(8):1073–1095

    Article  PubMed Central  PubMed  Google Scholar 

  21. Hempfing A et al (2011) Restoration of sagittal balance in treatment of thoracic and lumbar vertebral fractures. Orthopade 40(8):690–702

    Article  CAS  PubMed  Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to J. Bonacker.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bonacker, J., Janousek, M. & Kröber, M. Pregnancy-associated osteoporosis with eight fractures in the vertebral column treated with kyphoplasty and bracing: a case report. Arch Orthop Trauma Surg 134, 173–179 (2014). https://doi.org/10.1007/s00402-013-1912-5

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00402-013-1912-5

Keywords

Navigation