Case report Kyphoplasty for pregnancy-associated osteoporotic vertebral fractures Suheda Bayram a , Cagatay Ozturk b, * , Koncuy Sivrioglu a , Ufuk Aydinli c , Selcuk Kucukoglu a a Department of Physical Medicine and Rehabilitation, Uludag University Medical School, Bursa, Turkey b Istanbul Spine Center, Florence-Nightingale Hospital, Abide-i Hürriyet Caddesi No: 290 Şişli-İstanbul, 80220 Istanbul, Turkey c Department of Orthopedic Surgery, Uludag University Medical School, Bursa, Turkey Received 3 June 2005; accepted 30 November 2005 Available online 24 March 2006 Abstract We report a case of pregnancy-associated osteoporotic vertebral fracture treated by kyphoplasty. This case is important for being the first case of postpregnancy osteoporotic vertebral fracture treated with kyphoplasty. Although kyphoplasty is a very successful procedure in short-term pain relief for osteoporotic vertebral fractures, there is a critical need for randomized controlled trials demonstrating short-term complications of kyphoplasty including new vertebral fractures. © 2006 Elsevier SAS. All rights reserved. Keywords: Pregnancy-associated vertebral fracture; Kyphoplasty; Postprocedure new vertebral fracture 1. Introduction Traditional treatment for patients with osteoporotic vertebral fractures includes bed rest, analgesics, and bracing. This type of medical management obviously does nothing to restore spinal alignment, and lack of mobility itself can increase the rate of demineralization [1,2]. Because of the inherent risks and invasive nature, surgical treatment of osteoporotic verteb- ral compression fractures has been limited to cases in which there is concurrent spinal instability or neurological compro- mise. Postpregnancy spinal osteoporosis is a rare condition that can cause multiple vertebral fractures. Symptoms include back pain which usually occurs in a few months after delivery. We report here a woman who developed non-traumatic ver- tebral compression fractures over a lactation period of 6 weeks. This case is also important for being the first case of postpreg- nancy osteoporotic vertebral fracture treated with kyphoplasty. 2. Case report A 37-year-old woman developed sudden low back pain six weeks after a normal vaginal delivery with epidural anesthesia. She had been suffering from severe pain for nearly 1 month when evaluated for the first time. The pain increased with ac- tivity and there were no signs of numbness, weakness and ra- diation of pain. The severity of pain according to the visual analog scale (VAS) was 10 with activity. She took analgesics which were of no use and the pain kept increasing. The mater- nal weight gained through the pregnancy was 22 kg and the birth weight of the baby was 4200 g. She used to smoke 10– 15 cigarettes daily for 10 years. Lumbar examination revealed extremely limited flexion. No deficit was found when evaluated neurologically. Systemic ex- amination showed no signs of infectious, malignant or rheuma- tologic diseases. Compression fractures of the lumbar 2, 3, 4 vertebrae were seen in X-rays and magnetic resonance imaging (Fig. 1). Neur- al roots were not compressed within the canal or the foramina. There were no signs of metabolic, metastatic or infectious bone diseases in the laboratory and radiological findings. http://france.elsevier.com/direct/BONSOI/ Joint Bone Spine 73 (2006) 564–566 * Corresponding author. E-mail address: cgtyztrk@yahoo.com (C. Ozturk). 1297-319X/$ - see front matter © 2006 Elsevier SAS. All rights reserved. doi:10.1016/j.jbspin.2005.11.015