The Diagnosis of Type I Osteogenesis Imperfecta in A Patient with Acute Spinal Burst Fracture after Low-Energy Trauma and Its Operative Treatment: A Case Report

Abstract

Objective: To report a unique case of operatively and nonoperatively treated burst fractures of thoracolumbar spine in a single patient with type I osteogenesis imperfecta (OI), who previously had not been diagnosed as OI. Summary of background data:OI is a genetic disorder that causes bone fragility. Although spinal fractures may commonly occur in these subgroup of patients, there have been only a few case report of thoracolumbar burst fractures. And to our knowledge, there has not been reported case of operative treatment for acute burst fracture of thoracolumbar spine in a patient with OI, especially in type I. Methods:We report a case of 25-year-old woman who suffered unstable burst fracture of L1 after minor fall from a chair. The patient was treated operatively (anterior corpectomy, instrumentation and interbody fusion). She suffered stable burst fracture on T11 after a slip down in 10 months after the surgery, and was treated nonoperatively. Results:The patient was diagnosed as type I OI, based on the relatively minor nature of the trauma and blue sclerae and histories of multiple fractures of her and her father. Successful bony union and good spinal alignment were achieved. Conclusion:Anterior corpectomy, instrumentation and interbody fusion may be a feasible option for treatment of unstable burst fractures, even though the patients have any pathologic cause on their fractures. And any patient manifesting severe injuries that are caused by relatively minor trauma may have an underlying pathologic cause, including OI. They should be evaluated thoroughly to determine other cause and to be treated appropriately.