A rare case of non-traumatic, multi-level, bilateral pedicle fractures of the lumbar spine in a 60-year-old patient.
Eur Spine J
; 26(Suppl 1): 197-201, 2017 05.
Article
em En
| MEDLINE
| ID: mdl-28303382
ABSTRACT
INTRODUCTION:
We report a 60-year-old patient who sustained non-traumatic, multi-level, bilateral lumbar pedicle fractures in the setting of unilateral lumbar spondylolysis. A possible fracture mechanism is evaluated and a review of the literature is presented. Whereas contralateral pedicle fractures of lumbar vertebrae with unilateral spondylosis are well described in young athletes, there is only one case report of multi-level, bilateral pedicle fractures of the lumbar spine in a young patient who sustained a high-impact motorcycle accident. To our knowledge, this is the first report of multi-level, bilateral pedicular fractures of the lumbar spine without a history of trauma.METHODS:
The clinical case of a 60-year-old patient with lumbar pain radiating in both legs without antecedent trauma is presented. Besides an idiopathic primary adrenal failure, no further co-morbidities existed. Radiologic investigations showed acute bilateral pedicles' fractures of the lumbar vertebrae two to four (L2-4) and a unilateral spondylolysis L4-5. Dorsoventral instrumentation from L1 to L5 was performed in two steps.RESULTS:
The patient had no neurological deficits at discharge. Perioperative cortisol substitution was arranged and continued in the course. At final follow-up after 6 years the patient was pain-free and radiographs confirmed complete fusion of L1-5 with mild degeneration of the adjacent segments.CONCLUSION:
The presented fracture pattern has not been described to date. Because of multi-level involvement, instability requiring operative stabilisation was presumed and confirmed during surgery.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Fraturas de Estresse
/
Fraturas da Coluna Vertebral
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Vértebras Lombares
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article