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Postoperative images obtained at different time points. A: Immediate postoperative standing whole-spine lateral radiograph showing the following: L4-S1 of 43°, LL of 54°, PI-LL of 0.4°, PT of 13.4°, SS of 41.1°, and C7 SVA of 44.4 mm. Satisfactory alignment in terms of the Scoliosis Research Society-Schwab classification is obtained. B: Two-year postoperative standing whole-spine lateral radiograph showing the following: L4-S1 of 38.1°, LL of 49.9°, PI-LL of 2.1°, PT of 18.5°, SS of 33.5°, and C7 SVA of 69.9 mm. Reciprocal change was minimized with no mechanical failure. C: Two-year postoperative coronal (upper) and parasagittal (lower) reconstruction CT scans showing lumbopelvic reconstruction including the vertebral column replacement site achieving solid fusion.

Postoperative images obtained at different time points. A: Immediate postoperative standing whole-spine lateral radiograph showing the following: L4-S1 of 43°, LL of 54°, PI-LL of 0.4°, PT of 13.4°, SS of 41.1°, and C7 SVA of 44.4 mm. Satisfactory alignment in terms of the Scoliosis Research Society-Schwab classification is obtained. B: Two-year postoperative standing whole-spine lateral radiograph showing the following: L4-S1 of 38.1°, LL of 49.9°, PI-LL of 2.1°, PT of 18.5°, SS of 33.5°, and C7 SVA of 69.9 mm. Reciprocal change was minimized with no mechanical failure. C: Two-year postoperative coronal (upper) and parasagittal (lower) reconstruction CT scans showing lumbopelvic reconstruction including the vertebral column replacement site achieving solid fusion.

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FIG. 2. Preoperative images after 5 months of ROMO administration. A:...
FIG. 3. A: Postoperative anteroposterior and lateral radiographs...
FIG. 4. Postoperative images obtained at different time points. A:...
L5 osteotomy combined with adjuvant romosozumab therapy for L5 osteoporotic vertebral fracture–induced spinal deformity: illustrative case
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  • Mar 2025
BACKGROUND Spinal reconstruction of an L5 osteoporotic vertebral fracture (OVF) is a demanding surgery because of the condition’s rarity, poor bone quality, and anatomical reasons. To date, there has been little debate regarding the surgical strategy for L5 OVF and effective osteoporosis treatment. The authors report L5 osteotomy and adjuvant romos...
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Context 1
... to 43° postoperatively; PT decreased by 14°, from 27° preoperatively to 13° postoperatively. Sagittal full-length standing plain radiography showed satisfactory alignment in terms of the Scoliosis Research Society-Schwab classification, 20 with 54° of LL, 43° of L4-S1 LL, 0.4° of PI-LL, 13.4° of PT, 41.1° of SS, 31.1° of TK, and 44.4 mm of C7 SVA (Fig. 4A). After surgery, the patient's low back pain and leg pain improved gradually. Seven months after surgery, the adjuvant ROMO therapy was completed and switched to denosumab. At the 2-year follow-up, lumbopelvic reconstruction, including the vertebral column replacement site, achieved solid fusion, with minimal reciprocal change and no ...
Context 2
... surgery, the patient's low back pain and leg pain improved gradually. Seven months after surgery, the adjuvant ROMO therapy was completed and switched to denosumab. At the 2-year follow-up, lumbopelvic reconstruction, including the vertebral column replacement site, achieved solid fusion, with minimal reciprocal change and no mechanical failure ( Fig. 4B and C). The patient's Oswestry Disability Index improved from 64% to 24%, and the visual analog scale scores for low back pain and leg pain improved from 5.2 to 1.9 and from 8.6 to 0.9, ...