Asthmatic with Oral Sterid Usage Presenting with Multiple Fragility Fractures of Spine and Resultant Paraplegia: A Case Report

ABSTRACT

Glucocorticoid induced osteoporosis can cause vertebral fractures. However, neurological complications such as spinal cord compression are rare. Here, we report a case study of a 55-year-old asthmatic male patient, who was on high doses of oral as well as inhaled steroids for uncontrolled bronchial asthma, was presented to the emergency room with paraplegia and urinary incontinence for a week. He showed the clinical features of cord compression with a sensory level at T10. His workup revealed a fracture of vertebrae T6, T8, T12 and L2 with cord contusion and edema at multiple levels on MRI. Osteomalacia was present as well and DXA scan revealed the lowest individual T-score of –3.4 at the lumbar spine. Surgical intervention was deferred due to fragile nature of the fractured spine and patient was treated with teriparatide (recombinant PTH), oral steroid dose was gradually reduced, and supportive care was given.