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+A 65-year-old woman reported persistent back pain for almost 3 months.
+The symptoms would be severe after walking or changing positions and would be slightly relieve after taking painkillers.
+The patient described no pain or numbness in her legs.
+She also described no bowel or bladder voiding difficulties.
+The patient reported past medical history of hypertension, coronary heart disease, cerebral infarction, and asthma, all of which were well controlled.
+Physical exam demonstrated kyphosis of the thoracic spine in standing position and lumbar vertebra bend forward and backward straight activities were limited.
+There is obvious rap pain in back about T12 level.
+The patient's general medical examination was unremarkable in upper and lower extremity motor, stretch reflex, and sensory examinations.
+X-ray, computed tomography (CT), and magnetic resonance imaging (MRI) exams were performed after the patient in hospital (Fig.1).
+The lateral X-ray showed T12 fracture with 40° kyphotic cobb angle.
+CT showed an intravertebral vacuum sign.
+Sagittal T1-weighted MRI showed a decreased signal intravertebral vacuum cleft and posterior cortex breakage with cord compression in T12.
+Sagittal T2-weighted MRI showed an increased signal in the intravertebral vacuum cleft.
+The patient was diagnosed with Kümmell disease (Stage III).[9]
+The operation was performed under general anesthesia and prone position.
+A standard posterior exposure of the spine was given, pedicle screws were inserted in target vertebrae T10, T11, L1, and L2 under C-arm guidance.[10] The screws were connected on the left side with a temporary stabilizing rod.
+Laminectomy was performed to decompress and fully visualize the spinal cord.[10] Careful subperiosteal dissection was carried out on the right side to exposure the lateral wall of the T12 vertebral body until the anterior aspect was reached.
+The right side pedicle and articular process of the T12 vertebral body were removed.
+T11/T12 and T12/L1 intervertebral disks were also removed.
+Then, the temporary stabilizing rod was replaced by rod bended to the desired contour.
+Autologous bone graft and titanium mesh were placed in the intervertebral space.
+Another rod with the desired contour was connected on the right side.
+Adequate hemostasis was ensured and wound was thoroughly irrigated with saline.
+Drainage tube was inserted and the surgical wound was closed layer-by-layer.[10] Time from skin incision to completion of wound closure lasted 150 minutes, and estimated blood loss totaled 600 mL.
+Postoperatively, the patient was given preventive antibiotic treatment for 1 day, pain treatment for 3 days, and anticoagulant therapy for 1 week.
+The drainage tube was removed at 3 days postoperative when volume of drainage was less than 50 mL per 24 hours.
+Patient was allowed out of bed with a custom-made plastic orthosis at 1 week after operation.
+The plastic orthosis was kept for at least 3 months.
+The patient was allowed out of hospital at 12 days after operation when surgical suture had been removed.
+Pain assessments were conducted using the visual analogue scale (VAS).
+VAS for preoperative, 1 week after operation, and 1 year after operation were 9 score, 3 score, and 2 score, respectively, which demonstrated significant improvement.
+The patient resumed normal activities and returned to work at 3 months after operation.
+Kyphotic Cobb angle for preoperative, 1 week after operation, and 1 year after operation were 40°, 8°, and 17°, respectively, which demonstrated significant improvement (Fig.2).