| Summary: | Progressive thoracolumbar hyperkyphosis (aka hunchbacked) with a sagittal imbalance in an osteoporotic compression fracture might warrant surgical correction when conservative treatment fails. A 70-year-old woman presented with an L1 osteoporotic compression fracture after an L1 vertebroplasty and a short-segment (T12-L2) pedicle screw fixation. Because of the osteoporosis, the pedicle screws had loosened and a new L4 compression fracture occurred after the surgery. The author used the cortical bone trajectory screw technique for a long-segment posterior fixation after an anterior vertebral column resection. The outcome was good at the one-year follow-up. This technique provided a thoracolumbar Cobb angle correction of 20° and a sagittal vertical axis correction from 8.3 cm to 2.5 cm. This was the first reported case using the long-segment cortical bone trajectory screw technique to treat an osteoporotic compression fracture in progressive thoracolumbar hyperkyphosis. Keywords: Cortical bone trajectory screw, Osteoporotic compression fracture, Thoracolumbar hyperkyphosis
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