In a rare case, a 103-year-old woman with fractured spine started walking within a day after vertebroplasty. The was with vertebral compression fracture was admitted to Fortis, Noida. It was confirmed during an initial investigation based on an X-ray of her spine, CT scan, and MRI of her Dorsal spine. It is important to mention that vertebral compression fracture, which occurs when the vertebrae in the spine collapse, can lead to severe pain, deformity and in certain cases loss of height.
Post Diagnosis, team of doctors led by Dr. Rahul Gupta Director, Department of Neurosurgery, Fortis Hospital, Noida immediately intervened and performed Vertebroplasty on the patient. It is a medical procedure where access to inner organs or other tissue is done via needle-puncture of the skin under fluoroscopic guidance where 5 to 8 ml of bone cement is pushed inside the bone to reduce pain and provide strength. This magically relieves the symptoms and allows the patient to sit, stand and walk.
Discussing the rare case, Dr. Rahul Gupta said, “The patient was frail with slightly compromised cardiac functions. Given her age and severe pain, we decided to go ahead with a minimally invasive spine surgery. Under monitored anesthesia (mild sedation with local anesthesia) by our Neuro-anesthetist, we injected bone cement into the vertebral body. Kyphoplasty was also performed, in which a balloon was taken inside the bone and inflated to create space and increase the height of the vertebral body. The patient could stand and walk the very next day of the surgery. She is now pain-free and can do her daily chores by herself. This was a technically demanding procedure because the patient was conscious during the surgery and had to lie prone for an hour. She couldn’t move at all during the surgery since her bones were weak and there was a risk of new fracture, cement leakage or migration, and hematoma formation.”
“The procedure was an hour long and it is usually done for Osteoporosis or spine tumors leading to vertebral compression fractures. We routinely do this in our clinical practice, but it is very rarely done in patients above 90 years of age. Other treatment alternatives to this procedure are complete bed rest for 8 weeks or a major surgery in the form of fixation of the spine, for which the patient was not fit. A prolonged bed rest promotes Osteoporosis and can lead to a rapid decline in the mental and physical health of such a patient. It should be kept in mind that any procedure conducted in patients above 100 years of age is a stressful situation for the whole body. Any tilt in the balance can lead to sudden deterioration of health. Heart, kidneys, and brain are most vulnerable in such circumstances.” Dr. Gupta added.
Talking about the rare clinical achievement of the hospital, Mohit Singh, Zonal Director, Fortis Hospital Noida said, “It was a very challenging case considering the age of the patient. Despite all the odds, doctors at Fortis Hospital, Noida under the guidance of Dr. Rahul Gupta saved the life of the patient by adopting the correct line of treatment. Falls are a main cause of morbidity and disability in the elderly and lack of timely treatment can lead to permanent disability in the elderly.”
