Bone Abstracts

Introduction: Presence of osteosynthetic material in the spinal region may result in decreased musculoskeletal activity in certain spinal column segments, leading to vertebral bone mineral density changes.

Case study: The case involves a 12-year-old girl who was born prematurely, who complained of experiencing lower back pain after performing forward roll in the physical education class. The patient was born at 32 weeks of gestation by pelvic presentation, weighing 1350 g, and measuring 37 cm, with the Apgar Score of 2/4/6. She subsequently experienced motor and cognitive developmental delays. CT and MRI findings confirmed hemivertebrae in L1, scoliosis, narrowing of intervertebral spaces VTh11−VL2, disc protrusion at the VL5−S1 level with intense impression on the nerve root in the right neural foramen region. Egg Shell surgery was performed, involving instrumentation placement and compression-distraction positioning, after which the patient underwent postoperative rehabilitation therapy. Regular follow-ups and physical therapy were provided, in line with the recommendations for the surgery type performed. Bone mineral density in the lower lumbar vertebrae L2−L4 was assessed via DXA three years following the surgery, whereby Z score of 0.5 was obtained for both hip and spine, which is within normal limits. Owing to Vitamin D deficiency, supplements were prescribed. The patient remains free of any subjective symptoms, her gait schema has been corrected, and her endurance while standing as well as in all everyday activities has been improved.

Conclusion: Patients with osteosynthetic material in the spinal column require multidisciplinary follow-up, including bone metabolism parameter monitoring.

Keywords: bone mineral density, hemivertebrae, children

Disclosure: The authors declared no competing interests.