Case report shows spinal cord stimulation improves outcomes in an osteoporotic patient with sagittal imbalance, highlighting a potential alternative to fusion surgery.
Case: A 78-year-old woman had gluteal pain radiating to both lateral thighs and calves and progressive neurogenic claudication. Imaging revealed osteoporotic thoracolumbar compression fractures, L4 spondylolisthesis with severe L4–5 stenosis, and sagittal kyphosis. Spinopelvic parameters were not measured, owing to extreme forward-flexed posture. Given the high risk of instrumentation failure and complications, spinal cord stimulation (SCS) was selected after initiating osteoporosis therapy. The pain improved, with pain relief and ambulatory function maintained at 18 months without surgery. Conclusion: SCS may be an alternative to fusion in selected osteoporotic patients with severe sagittal imbalance and lumbar radiculopathy.
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Arimura et al. (2026) studied this question.
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