Percutaneous vertebroplasty and compression screw fixation for osteoporotic vertebral fractures with bilateral pedicle fractures: A case report

Figure 1 Preoperative imaging examination. A-D: Preoperative lumbar spine digital radiography in anteroposterior, lateral, and flexion-extension views, indicating compression change of L4 vertebrae; E-G: Preoperative magnetic resonance imaging included T1-weighted imaging (E), short tau inversion recovery imaging (F), and axial images at the inferior margin of the L3/4 intervertebral disc level (G), indicating bone marrow edema of L4 vertebrae and spinal canal stenosis at the L3/4 intervertebral disc level; H and I: Sagittal (H) and axial (I) views of the L4 vertebra on preoperative computed tomography, the pedicle fracture sites were marked within the white frame.

Figure 2 Intraoperative C-arm fluoroscopic imaging. A and B: Percutaneous bilateral pedicle puncture; C: Intraoperative fluoroscopy-guided polymethyl methacrylate injection; D: Insertion of a headless cannulated compression screw into the vertebral body along the Kirschner wire; E and F: An identical procedure on the contralateral side (E) and assessment of the cement distribution and positioning of the internal fixation via fluoroscopic imaging (F).

Figure 3 Computed tomography and magnetic resonance imaging images obtained during the follow-up examination performed on the second postoperative day. A and B: Postoperative sagittal and axial computed tomography images of the lumbar spine; C: Postoperative sagittal short tau inversion recovery image of lumbar spine magnetic resonance imaging (MRI); D: Postoperative lumbar MRI transverse section image acquired at the lower margin of the L3/4 intervertebral disc level.

Figure 4 Lumbar computed tomography and magnetic resonance imaging images obtained at the follow-up examination three months after surgery. A and B: Postoperative three-month lumbar spine axial (A) and sagittal (B) computed tomography images; C: Postoperative three-month sagittal short tau inversion recovery image of lumbar spine magnetic resonance imaging; D: Postoperative three-month lumbar magnetic resonance imaging transverse section image acquired at the lower margin of the L3/4 intervertebral disc level.