Non-Traumatic Compression Fractures of the Thoracic Spine Following a Seizure - Treatment by Percutaneous Kyphoplasty

Abstract

A 26-year-old male presented with acute mid-thoracic back pain following a witnessed grand mal seizure. There was no trauma and the patient was on steroids for systemic lupus erythematosus. X-rays and CT scans of the thoracic spine revealed compression fractures at T5 and T6, with 50 % loss of vertebral height and kyphosis. He underwent percutaneous kyphoplasty of both vertebrae, with symptomatic improvement. Non-traumatic compression fractures of the thoracic spine following seizures are a rare injury. This may be related to the compressive forces exerted on the vertebral column by the contractions of the truncal muscles, during a seizure. These compression fractures are suitable for treatment by minimally invasive techniques, such as kyphoplasty.

Seizures - vertebrae - compression fractures - kyphoplasty

References

• 1 Kelly J P. Fractures complicating electroconvulsive therapy and chronic epilepsy.  J Bone Joint Surg [Br]. 1954;  36 70-79
• 2 Vasconcelos D. Compression fractures of the vertebra during major epileptic seizures.  Epilepsia. 1973;  14 323-328
• 3 McCullen G M, Brown C C. Seizure induced thoracic burst fractures. A case report.  Spine. 1994;  18 77-79
• 4 Youssef J A, McCullen G M, Brown C C. Seizure-induced lumbar burst fracture.  Spine. 1995;  20 1301-1303
• 5 Garfin S R, Yuan H A, Reiley M A. New technologies in spine: Kyphoplasty and vertebroplasty for the treatment of painful osteoporotic fractures.  Spine. 2001;  26 1511-1515
• 6 Kumar S K, Freeman B J. Quadriplegia following grand mal seizures.  Injury. 1999;  30 626-629
• 7 Ballock R T, MacKersie R, Abitbol J, Cervilla V, Rosnick D, Garfin S R. Can burst fractures be predicted from plain radiographs?.  J Bone Joint Surg [Br]. 1992;  74 147-150