Multilevel Compression Fracture Initiated by Unrestrained Electroconvulsive Therapy for Treatment Resistant Depression Case Report.

Background: Depression is the most common cause of emotional disorders in older adults with electroconvulsive therapy (ECT) as the preferred treatment for older adults. ECT utilizes a controlled therapeutic seizure resulting in repetitive muscle contractions, which carries the risk of fractures and dislocations.

Case report: This is an unusual case of a 69-year-old man with a history of treatment-resistant depression developing severe midback pain and a multilevel compression fracture after treatment without a well-defined incidence following utilization of ECT. Anteroposterior and lateral x-rays of the thoracic spine demonstrated a 2-level compression. The patient was a candidate for kyphoplasty. Bone density was age appropriate. On follow-up, the patient denied pain with healing of the fracture without augmentation. Initiation of physical therapy was recommended.

Conclusions: Individuals with age-appropriate nonosteoporotic bones can develop fractures during ECT. Back pain following ECT may be associated with a vertebral compression fracture, especially in older adults.