Fracture Above Fusion a.k.a Proximal Junctional Kyphosis
Patient History: 68-year-old woman presented with severe back pain and enlarging hump on her back. She was experiencing occasional shortness of breath night and found it difficult to sleep on her back. She had a history of scoliosis which she was aware of. She noticed worsening of her shoulder balance, increasing back pain and leaning leftward.
She did well with her first surgery to correct the scoliosis. However, 2 months after surgery she experienced a fracture of the top vertebrae leading to paraplegia. She was taken to the operating room immediately where the spinal cord compression was relieved and vertebral column realignment corrected.
Surgery: The patient's first surgery was a T3–pelvis scoliosis correction and fusion. She did very well with this surgery. Unexpectedly, she experienced a fracture of the top vertebral level. This resulted in immediate paraplegia. Dr. Rahman performed a complex spinal decompression and osteotomy known as a vertebral column resection. This was done in order to relieve the circumferential pressure off her spinal cord. This procedure is reserved for only the most severe spinal cases and requires experience, exception of training and meticulous detail in order to be successful.
T3 Vertebrae Top of Fusion Fracture
Outcome: After months of rehabilitation, the patient walked into Dr. Rahman's office without the use of a cane or walker. The patient is now a community ambulator without the use of assistive devices.