Osteoporotic vertebral fracture most common located at thoracolumbar junction, whereas most spondylolisthesis at L4-5 is six to 10 times more frequent involved than adjacent level. Concomitant compressed fracture with lumbar spondylolisthesis is rarely reported.

To report an unusual case concomitant osteoporotic compressed thoracic fracture with lumbar spondylolisthesis and severe comorbidity.

A 68 years old female complaining 3 months severe low back pain and right thigh pain after falling on the floor. On physical examination, she had bilateral foot drop, there was no sensory loss and neither any bowel and bladder involvement with cardiovascular problem 70% left artery coronary obstruction on cardiac angiography.

Magnetic resonance imaging (MRI) D12 compression fracture with spinal cord and thecal sac compression and spondylolisthesis L5-S1.

L5 laminectomy, L4/5 and S1 posterior stabilization, D-12 laminectomy and transpedicular vertebroplasty and posterior stabilization of D11-L1.

The pain was significantly reduced after the surgery.

Open surgery among osteoporotic compression fracture in thoracic spine and degenerative spondylolisthesis in lumbar spine needs further evaluation regarding comorbid disease which often present in advancing age.

Pawar SG, Ramani P, Ibrahim IS. Major Spinal Surgery Procedure on a High Cardiovascular Risk Patient with Symptomatic Neural Compression due to 1: Osteoporotic T12 Compression Fracture along with 2–L5/S1 Spondylolisthesis. J Spinal Surg 2014;1(3):138-140.