Percutaneous Para-Pedicular Vertebroplasty for an Uppermost Instrumented Vertebral Fracture: A Case Report

Study Design: Case report. Objectives: This case report presents a surgical technique used to perform vertebral anterior column stabilization in an elderly male patient who had recently been diagnosed with an uppermost instrumented vertebral fracture (IVF) at the site of previous posterior lumbar instrumented fusion (PIF). Summary of Literature Review: Although conservative treatment is also used for IVF, the proximal junction of PIF is an area where the compression load is concentrated biomechanically, so the uppermost IVF often requires surgical treatment. This may require fixation of extended segments and more surgical morbidity. Materials and Methods: A 73-year-old male patient who had undergone PIF from L2 to L5 more than 20 years previously was recently diagnosed with uppermost IVF without a traumatic event. He complained of persistent back pain even after 2 months of conservative treatment. He ultimately underwent percutaneous vertebroplasty through the parapedicular approach. Result: The patients showed a favorable outcome at a 1-year follow-up. Conclusions: Percutaneous vertebroplasty through the parapedicular approach for uppermost IVF at the site of a previous PIF might be a feasible and less invasive alternative.