Yi J, MacAllister MM, Caruso JP, Palmisciano P, Johnson ZJ, Umana GE, Al Tamimi M, Bagley CA, Aoun SG. Image-Guided Percutaneous Multilevel Pediculosynthesis for the Treatment of Contiguous Pedicle Stress Fractures: A Technical Case Report Motion-Preserving Treatment of Contiguous Lumbar Pedicle Stress Fractures: A Technical Surgical Report.
World Neurosurg 2023;
174:132-136. [PMID:
36965662 DOI:
10.1016/j.wneu.2023.03.037]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 03/07/2023] [Accepted: 03/08/2023] [Indexed: 03/27/2023]
Abstract
BACKGROUND AND IMPORTANCE
Nontraumatic pedicle fracture is uncommon, with sparsely described cases of conservative management versus surgical treatment by open fusion or percutaneous fixation.
CLINICAL PRESENTATION
We report the case of a 60 year old woman with nontraumatic L4 and L5 pedicle fracture who developed additional pedicle fractures at L3 while undergoing conservative management in a brace. The patient underwent percutaneous pediculosynthesis with screw fixation without fusion at L3-5 bilaterally. This led to fracture healing with good radiographic result and resolution of her symptoms.
CONCLUSION
A trial of conservative management is typically warranted in most cases of non-traumatic pedicle fracture, but there is risk of refractory or progressive symptoms as well as subsequent fracture. Minimally invasive fixation is a viable surgical option that can be used in multilevel fractures.
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