Vertebral Compression Fracture after removing Implants in A Patient undergoing Posterior Lumbar Interbody Fusion: A Case Report and Literature Review

Abstract

Posterior lumbar interbody fusion (PLIF) is a well-known method for treating spinal diseases in which adjacent segment disease (ASD) is a representative complication. To correct ASD, posterior fusion is extended to the upper or lower segment, and the previous instruments are removed. However, there have been a few reports of complications after instrument removal. Here, we report on a case of compression fracture that occurred without history of trauma after ASD revision and instrument removal surgery. A 68-year-old woman underwent PLIF at L3-L5 and was hospitalized for treatment of ASD. She underwent oblique lumbar interbody fusion at L2-L3 after removal of the previous screws. One month later, she visited the hospital with sudden lower back pain. Plain radiography revealed a compression fracture of L4. The patient's pain was relieved after conservative treatment. Our findings show that instrument removal during revision operations should be performed carefully because it can lead to compression fracture without history of trauma.