• Feng-Yu Liu, Zheng-Qi Zhao, Liang Ren, Zhen-Fang Gu, Feng Li, Wen-Yuan Ding, and Xian-Ze Sun.
• Department of Spine Surgery, The Third Hospital of Shijiazhuang.
• Medicine (Baltimore). 2018 Dec 1; 97 (52): e13846.

RationaleThe kyphosis caused by old osteoporotic vertebral compression fracture usually requires osteotomy to correct it. Various osteotomy techniques have been reported, but each has its own advantages and disadvantages.Patient ConcernsWe reviewed 2 cases of old osteoporotic vertebral compression fractures with kyphosis in our hospital. One patient complained of persistent low-back pain, another patient complained of low-back pain and weakness of both lower extremities.DiagnosisOld osteoporotic vertebral compression fractures with kyphosis were diagnosed based on computer tomography and magnetic resonance imaging.InterventionsWe performed modified grade 4 osteotomy for 2 patients.OutcomesBoth patients said significant improvement in preoperative symptoms, and x-ray showed that the kyphosis was corrected. Both patients were satisfied with the treatment at the last follow-up, and the kyphosis was not aggravated.LessonsModified grade 4 osteotomy is an effective option for the treatment of old osteoporotic fracture with kyphosis. It can restore the spine sequence and achieve better clinical result.

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