Multiple Lumbar Compression Fractures Following a New-Onset Seizure: A Case Report

Vertebral compression fractures (VCFs) occur when axial forces exceed the vertebra's strength, such as those occurring with low-impact injuries in osteoporotic patients. In healthy individuals, VCFs require significant trauma. Though rare, seizures can cause spinal compression due to muscle contractions. These fractures often affect the mid-thoracic spine and are usually asymptomatic due to the postictal state. This case discusses an uncommon incidence of multiple lumbar fractures following a seizure, otherwise known as seizure-induced spinal fractures. A 50-year-old male with a past medical history of hypertension, type 2 diabetes, and obesity presented to the emergency room (ER) after being found unresponsive following an unwitnessed seizure. The patient experienced a witnessed generalized tonic-clonic seizure in the ER with associated bladder incontinence. CT of the head was performed to rule out an acute cerebrovascular accident, and he was later discharged home with levetiracetam. The patient returned to the ER three days later with severe lower back pain, and a CT of the lumbar spine found compression fractures at L1, L4, and L5. Neurosurgery was consulted and subsequently performed kyphoplasty. Follow-up evaluation showed recovery with no reported pain or neurological deficits. Clinicians should maintain a high index of suspicion for compression fractures in the lumbar spine after a patient experiences a new-onset convulsive seizure, especially for those with risk factors.