Seizure-induced thoracolumbar burst fracture secondary to cirrhosis: A case report

•Treatment of seizure with hepatic encephalopathy-induced thoracolumbar burst fracture.•Spinal surgery on a patient with liver cirrhosis has a high risk of poor outcomes.•In secondary osteoporotic spine, surgical treatment should be done with caution. There are several reports about spinal fracture after the seizure. Mostly thoracic or thoracolumbar fracture, and most of these cases, there is no neurologic symptom and heal spontaneously. However, this report is the first presentation of neurological compromised high risk in Child-Pugh class C liver cirrhosis patient treatment who had secondary osteoporosis spinal fracture. A 50-year-old man was requested for cooperative medical consultation from the internal medicine department who admitted for treatment of hepatic encephalopathy due to alcoholic liver cirrhosis. During chest x-ray checked, he had a generalized tonic-clonic seizure attack for 2 min; after that, hip, knee, and ankle joint had no motor power, and contraction of toes (grade 1/5) remained, and the sensation was significantly decreased below L2 dermatome level. The patient had alcoholic liver cirrhosis, Child-Pugh class C and secondary osteoporosis. Surgical treatment was required, but the patient's condition was poor and had a high bleeding tendency with below 20,000/mcL platelet count, so surgical treatment was high risk. After a lot of contemplation, surgery was performed for early rehabilitation and quality of life. The operation was performed in two stages. Secondary osteoporosis is being treated with bisphosphonate with vitamin D. To our best Known, This case report is the first description of the treatment of Seizures with hepatic encephalopathy induced thoracolumbar burst fracture in alcoholic liver cirrhosis patient. Spinal surgery of Child-Pugh class c patient was expected bad results, but we reported good results.