Chance fracture after pedicle screw fixation. A case report.

Abstract

A case of a Chance fracture through an instrumented pedicle is presented. The radiographic and intraoperative findings and management of this complication are reported. To increase awareness of the complications of transpedicular screw fixation and to suggest a form of management of this unusual complication. To the authors' knowledge, this is the first reported case of such a vertebral fracture occurring after pedicle screw fixation. A 44-year-old man with athetoid cerebral palsy and a progressive thoracic kyphosis sustained a Chance fracture at the caudal end of the segmental instrumentation construct. Surgical intervention, including fracture reduction and extension of the instrumented fusion to the pelvis, provided effective restoration of physiologic sagittal alignment. Chance fracture after pedicle screw fixation can be successfully managed with surgical intervention.