Betül TOYGAR, Nurdan KOTEVOĞLU, Hayal AHMETOĞLU

Gebelik Sonrası Osteomalasiye Bağlı Vertebral Fraktür

Yirmiyedi yaşında bayan hasta şiddetli sırt ağrısı şikayeti ile başvurdu. 7 ay önce doğum yapan hastanın doğum sonrası başlayan sırt ağrıları son 4 aydır çok şiddetlenmişti. Hasta ayakta dik durunca zorlanıyor ve daha çok ağrı duyuyordu. Travma öyküsü yoktu ve halen bebeğini emziriyordu. Fizik muayenesinde kifotik duruş +, torakal bölgede fleksiyon ve ekstansiyon çok ağrılı , minimal kısıtlı, presyonla torakal 8,9, 10 . vertebralar şiddetli hassas bulundu. Nörolojik defisit bulunmayan hastanın torakal MRI tetkiklerinde T8,T9,T11,T12 vertebralarda belirgin yükseklik kaybı , torakal kifoz bulguları saptanması üzerine hastanın dansitometrik ölçümleri ve kan tetkikleri istendi. DEXA ile yapı- lan ölçümde t skorları L1. -2,6, L2: -3,2, L3:-2,9, L4:-3,3 femur boynu: -2,3 olarak saptandı . Kan tetkiklerinde 25 hidroksivit D: 10,3 Ca: 10,2, parathormon : 83 pg/ml olan hastada gebeliğin tetiklediği osteomalaziye bağlı torakal vetrebra fraktürü tanısı konularak tedavisi başlandı.

Anahtar Kelimeler:

Osteomalasi, vertebra fraktürü, gebelik

Postpartum Vertebral Fracture Due to Osteomalacia

Twenty-seven years old woman complaining of severe back pain beginning after giving birth to a baby seven months ago with increase in her complaint for last four months.She had difficulty in standing in erect position and feel much more severe pain. She had no trauma and still on lactation. Physical examination revealed a kyphotic posture with minimal flexion and extension limitation but severe pain. Toracal 8,9,10th vertebrae were tender on palpation. She did not have any neurological sign. MRI examination showed severe vertebral compression on dorsal 8,9,11,12 vertebrae. BMD results were as follows: L1:- 2.6, L2:-3.2, L3:-2.9, L4:-3.3, Femur neck -2.3. She had low 25-hydroxivitamin D level as 10.3 ng /ml with serum calcium10.2 mg and parathormon 83 pg/ml .She was diagnosed as osteomalasia triggered by pregnancy and her medical therapy was arrenged accordingly.

Keywords:

Osteomalacia, vertebral fracture, Pregnancy,

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