Reactive Sclerosis of the Pedicle Associated with contralateral Spondyloysis

Araki, Tokuichi; Harata, Seiko; Nakano, Keisuke; Satoh, Takahiro

doi:10.1097/00007632-199211000-00028

Cited by 35 publications

(24 citation statements)

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“…Pedicular stress fracture associated with contralateral spondylolysis has rarely been reported [3,13,21,29]. Pedicle fracture most often occurs due to abnormal stress after spinal surgery.…”

Section: Discussionmentioning

confidence: 99%

A biomechanical study of lumbar spondylolysis based on a three‐dimensional finite element method

Chosa

Totoribe

Tajima

2004

Journal Orthopaedic Research

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Biomechanical analyses under compression only, and for a combination of flexion, extension, rotation, and lateral bending were performed to evaluate the stress of the interarticular portion of the lumbar vertebra using a nonlinear three-dimensional finite element method. A detailed three-dimensional L4-L5 motion segment model was developed that took into consideration the material nonlinearities of ligaments and annular fibers and the contact nonlinearities of facet joints. For a more accurate examination, the separation of cortical bone and cancellous bone for both posterior and anterior elements were also considered. The stress in the pars interarticularis was weakest under compression alone, but stronger under compression with lateral bending loading, with flexion, with rotation, and with extension. Under each loading condition, the region of the stress concentration was consistent with the separated region of the spondylolysis observed in clinical situations. Since the stress in the pars interarticularis was high under extension and rotation in particular, those loadings were suggested to be relatively high risk factors leading to spondylolysis.

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Section: Discussionmentioning

confidence: 99%

A biomechanical study of lumbar spondylolysis based on a three‐dimensional finite element method

Chosa

Totoribe

Tajima

2004

Journal Orthopaedic Research

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“…Some cases of unilateral lumbar pedicle fractures related to contralateral spondylolysis 3,6,7,22,23 or following surgical fusion have been reported. 8,11,12,15,18,19,21 However, reports of bilateral pedicle fractures without significant trauma, surgery, or a bony abnormality are limited.…”

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confidence: 99%

Posterior osteosynthesis of a spontaneous bilateral pedicle fracture of the lumbar spine

Han¹,

Hyun²,

Jahng³

et al. 2016

SPI

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Spontaneous bilateral pedicle fractures of the lumbar spine are rare, and an optimal surgical treatment has not been suggested. The authors report the case of a 50-year-old woman who presented with low-back pain and right leg radiating pain of 1 year’s duration. Radiological studies revealed a spontaneous bilateral pedicle fracture of L-5. All efforts at conservative treatment failed, and the patient underwent surgery for osteosynthesis of the fractured pedicle using bilateral pedicle screws connected with a bent rod. Her low-back and right leg pain were relieved postoperatively. A CT scan performed 3 months postoperatively revealed the disappearance of the pedicle fracture gap and presence of newly formed bony trabeculation. In rare cases of spontaneous bilateral pedicle fracture of the lumbar spine, osteosynthesis of the fractured pedicle using bilateral pedicle screws and a bent rod is a motion-preserving technique that may be an effective option when conservative management has failed.

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“…Unilateral spondylolysis associated with sclerosis and hypertrophy of the contralateral side of the neural arch is well described in the literature [1][2][3][4][5][6][7][8]10]. Pedicle fractures also occurred following contralateral isthmic spondylolysis, secondary to a weakening of the neural arch with resulting increased stress across the contralateral pedicle [1,2,4].…”

Section: Discussionmentioning

confidence: 99%

“…Pedicle fractures also occurred following contralateral isthmic spondylolysis, secondary to a weakening of the neural arch with resulting increased stress across the contralateral pedicle [1,2,4]. Unilateral spondylolysis associated with pedicular fracture has been described in competitive sport patients [2,5,10]. To explain pedicular fracture, authors usually insist on the asymmetric character of sports activities, requiring rotary movements.…”

Section: Discussionmentioning

confidence: 99%

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Acute L5 pedicle fracture and contralateral spondylolysis in a 12-year-old boy: a case report

Vialle¹,

Mary²,

Carvalho³

et al. 2007

Eur Spine J

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Acute unilateral L5 pedicle fracture associated with a pre-existing contralateral spondylolysis is a rare lesion. We report a case in a non-competitive 12-year-old boy. We present the clinical, radiological and specific management of this rare condition. The clinical and radiological draft of this patient was reviewed. The followup was 30 months after fracture healing. Some cases reported in the literature were analyzed and our clinical findings and therapeutic strategy was compared and discussed. Non-operative treatment was done including fulltime bracing in a modified Boston brace incorporating one thigh for 3 months. Plain radiographs and computed tomographic (CT)-scan performed at 3 and 6 months showed progressive healing of the pedicle fracture and no modification of the contralateral isthmic spondylolytic lesion. At final follow-up, the patient was asymptomatic and resumed all his activities. In skeletally immature patients, we think that conservative treatment should be considered as a treatment option for this unusual injury.

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Reactive Sclerosis of the Pedicle Associated with contralateral Spondyloysis

Cited by 35 publications

References 0 publications

A biomechanical study of lumbar spondylolysis based on a three‐dimensional finite element method

A biomechanical study of lumbar spondylolysis based on a three‐dimensional finite element method

Posterior osteosynthesis of a spontaneous bilateral pedicle fracture of the lumbar spine

Acute L5 pedicle fracture and contralateral spondylolysis in a 12-year-old boy: a case report

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