Usefulness of Ligamentotaxis With Balloon Kyphoplasty for Delayed Lumbar Radiculopathy Resulting From Osteoporotic Vertebral Fracture: A Case Report.

Osteoporotic vertebral fractures (OVF) commonly occur at the thoracolumbar junction, and delayed neurological deficits are rare. Here, a 76-year-old female presented with low back pain and the late onset of symptoms characterized by lumbar radiculopathy. She had been suffering from lower back pain for four weeks and developed lumbar radiculopathy in the left L3 area. The lumbar magnetic resonance (MR) and three-dimensional computed tomography (3D-CT) demonstrated an L3 OVF with bone fragments at the entrance of the neural foramen. She ultimately underwent a balloon kyphoplasty (BKP), as conservative treatment was unsuccessful for six weeks. The bone fragment had been reduced with ligamentotaxis caused by BKP, and the pain in the left L3 area disappeared immediately after the surgery. 3D-CT is established in addition to MR for the diagnosis of delayed radiculopathy by lumbar OVF. BKP alone using the ligamentotaxis of the posterior longitudinal ligament is a minimally invasive and rational surgical method.