骨粗鬆症性陳旧性圧迫骨折に両側椎弓根骨折を生じた１例
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概要
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We report a rare case of fracture of bilateral pedicles following osteoporotic vertebral compression fracture. A 59-year-old woman complained about pain in her back, right buttock and right leg. Radiography revealed non-union of the vertebral body following L2 compression fracture. Further, myelogram showed incomplete block at L2 vertebral upper portion, and computerized tomography myelography (CT-M) bilateral L2 pedicle fractures; a dynamic radiograph in her extention position showed a reduction of the non-union site. Follow up examinations were performed at two weeks and three months after the procedure, afterwards once per two months. Posterolateral fusion (PLF) using autologous bone graft with pedicle screws through the fractured pedicles was performed at the extended position.Eight months after surgery, plain CT indicated bone union in the PLF and pedicle fractures to be healed. Ten months after surgery, the Japanese Orthopaedic Association (JOA) score improved by 66.7% and the correction loss of L2 vertebra had finally reached down to 26.7%. At the end of the follow-up period, her leg pain was gone and she was able to walk without any supports. We believe that in this particular case, stresses may have been concentrated on bilateral pedicles in vertebral pseudoarthrosis during lumbar motion and led to pedicle fractures. To the best of the authors'knowledge, this was the first report of pedicle fractures following vertebral pseudoarthrosis.
- 中国・四国整形外科学会の論文
中国・四国整形外科学会 | 論文
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