Image-Guided Percutaneous Multilevel Pediculosynthesis for Treatment of Contiguous Pedicle Stress Fractures: Technical Case Report.

Yi, Julia; MacAllister, Matthew C; Caruso, James P; Palmisciano, Paolo; Johnson, Zachary D; Umana, Giuseppe E; Al Tamimi, Mazin; Bagley, Carlos A et al. · World Neurosurg · 2023

case_report · Level V

Where this comes from

Abstract

Nontraumatic pedicle fracture is uncommon, with sparsely described cases of conservative management versus surgical treatment by open fusion or percutaneous fixation. 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. The treatment led to fracture healing with good radiographic result and resolution of her symptoms. A trial of conservative management is typically warranted in most cases of nontraumatic pedicle fracture, but there is risk of refractory or progressive symptoms and subsequent fracture. Minimally invasive fixation is a viable surgical option that can be used in multilevel fractures.

Medical subject headings