Bilateral pedicle stress fracture in a patient with osteoporotic compression fracture

Doita, Minoru; Ando, Yumiko; Hirata, Soichiro; Ishikawa, Hitoshi; Kurosaka, Masahiro

doi:10.1007/s00586-008-0816-5

Cited by 25 publications

(23 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Bilateral pedicle stress fracture is a rare entity and we found that few cases have been reported in literature and underlying causative factors like previous spine surgery, spondylolysis or spondylolisthesis were described in these cases (2,(6)(7)(8)13). The pedicle may be exposed to increased forces after spine surgery, especially after spinal fusion, and the few pedicle stress fracture cases after surgery that occurred at the most proximal level of the fusion have been reported (3,9,12).…”

Section: Discussionmentioning

confidence: 82%

See 1 more Smart Citation

Multi-level, bilateral pedicle fractures: case report

Karabay

Ozer²,

Ada³

2014

Turkish Neurosurgery

View full text Add to dashboard Cite

Bilateral pedicle fracture is an extremely rare entity and few cases have been reported in literature. A case of bilateral multi-level pedicle fractures involving four lumbar vertebrae is being presented. Bilateral pedicle stress fracture at L1 -L4 was observed in a 61-year-old woman presented with low back pain. There was no any predisposing factor like trauma, spinal surgery, smoking or alcohol consumption except mild osteoporosis and bisphosphonate usage in the patient's medical history. We are unable to determine whether the fractures are related to osteoporosis or bisphosphonate therapy but these are the only remaining suspected reasons in the present case. Further studies are required to define the effect of bisphosphonates usage on vertebral segments.

show abstract

Section: Discussionmentioning

confidence: 82%

“…Bilateral multi-level pedicle fracture is an extremely rare condition and is generally associated with previous spine surgery or stress-related activities (2,6,7). We report a case of bilateral multi-level (four levels) pedicle fracture that was not associated with any obvious risk factors except bisphosphonate usage for osteoporosis.…”

Section: Introductionmentioning

confidence: 94%

Multi-level, bilateral pedicle fractures: case report

Karabay

Ozer²,

Ada³

2014

Turkish Neurosurgery

View full text Add to dashboard Cite

show abstract

“…There has been a case of stress fracture of both pedicles of L4 in a patient with osteoporotic compression fracture of L5 [7]. This patient had postmenopausal osteoporosis and did not have a history of major trauma or surgery.…”

Section: Discussionmentioning

confidence: 99%

“…In osteoporosis, the decreased vertebral body height can generate abnormal muscular stress. In addition, spinous processes show decreased elastic resistance [7]. Abnormal muscular stress on bones with decreased elastic resistance can result in fracture.…”

Section: Discussionmentioning

confidence: 99%

Spinous process fractures in osteoporotic thoracolumbar vertebral fractures

Seo

Park²,

Park³

et al. 2011

BJR

View full text Add to dashboard Cite

Objectives: To evaluate the incidence and pattern of spinous process fractures (SPFs) in patients with osteoporotic compression fractures (OCFs) of the thoracolumbar spine. Methods: Spinal MRI or CT of 398 female patients (age range 50-89 years, mean age 70 years) who had OCFs in the thoracolumbar spine were retrospectively reviewed. The incidence, location and imaging results for the SPFs were evaluated. Results: Of the 398 patients who had thoracolumbar OCFs, 14 (3.5%) had SPF. In six patients with single compression fractures, the SPF occurred at the level just above the vertebral compression fracture. In six out of seven patients with multiple continuous compression fractures, the SPF occurred just one level above the uppermost level of the compression fracture. The remaining one patient who had thoracolumbar spinal fixation at T12-L2 with continuous compression fractures in T12-L5 had a SPF in L2. In one patient who had multiple compression fractures in discontinuous levels (fractures at T10 and L1, respectively), the SPF occurred at T12. The directions of the fractures were vertical or oblique vertical (perpendicular to the long axis of the spinous process) in all cases. Conclusion: In the presence of an OCF in the thoracolumbar spine, a SPF was found in 3.5% of cases, and most of the fractures were located just one level above the compression fracture. Therefore, in patients who have OCF, the possibility of a SPF in the level just above the compression fracture should be considered. Osteoporosis is a common disease owing to an increase in the population of older people. Osteoporosis is a disease that induces bone fragility, caused by a decrease in trabecular bone, and the resulting fracture is called an insufficiency fracture. The most common osteoporotic compression fractures occur in the spine, sacrum, pubis, femoral neck and wrist [1].Although the most common methods for imaging vertebral fractures are still spinal radiographs, benign spinal compression fractures are commonly detected by MRI or CT on osteoporotic patients with back pain. Sometimes, it is difficult to differentiate a benign spinal compression fracture from a malignant cause of the spinal compression fracture. However, in most cases, a benign spinal compression fracture shows some specific features: a low-signal-intensity band on T 1 and T 2 weighted images, spared normal bone marrow signal intensity of the vertebral body, retropulsion of a posterior bone fragment and multiple compression fractures [2]. A relationship between osteoporosis and benign spinal compression fractures, including insufficiency fractures, has been reported. A study examining the relationship between benign compression fractures of the spine and insufficiency fractures of the sacrum has also been reported [3]. However, there have been few reports of spinous process fractures in the osteoporotic spine [4]. Moreover, there have been no studies examining the relationship between spinous process fractures and benign compression fractures of the spine.We have noted ind...

show abstract

“…Bilateral pedicle fracture of the vertebrae is uncommon and is especially rare without trauma or high velocity activity. Even more uncommon is neurologic deficit following these fractures [2]. Here we present a case of a 67year-old patient who presented with acute osteoporotic compression fracture of the lumbar 5 vertebra and bilateral pedicle fractures of the fourth and fifth lumbar vertebrae following an episode of coughing secondary to tracheitis.…”

Section: Introductionmentioning

confidence: 97%