Vertebral Fracture Complications following Radiation Therapy: Report of Two Cases

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  • 放射線障害による脊椎圧迫骨折と思われた２症例

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We observed the outbreak time of a spinal compression fracture following radiation therapy and its natural course. [Case] Case 1 was a 88-year-old, woman. NTX66.9. Underwent cobalt irradiation 54Gy for esophageal cancer. Three months after irradiation, the first lumbar vertebra was found to de compressed, and low back pain occured. Vacuum cleft phenomenon in X-P appeared after two weeks, but anterior callus formation appeared in eight weeks, after which the low back pain disappeared. Case 2 was a 77-year-old woman. NTX86.5. Underwent irradiation 69Gy for uterine carcinoma. Six months after the irradiation, the fourth / five lumbar vertebra were found to be compressed. Great collapse occured in X-P after two weeks, but stabilized and did not aggravate thereafter. Low back pain also disappeared. [Conclusion] Radiotherapy affects bone cells (osteoblasts, osteoclasts), inhibiting bone remodeling. As a result, deficient elastic resistance occurs. Vertebral bodies are also compressed in such a situation. After that normal callus formation starts from adjacent normal bone cells. The compression fracture observed ranged from three to six months after radiation. Natural course is well. Therefore conservative therapy is recommended.

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