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

Julia Yi; Matthew C. MacAllister; James P. Caruso; Paolo Palmisciano; Zachary D. Johnson; Giuseppe E. Umana; Mazin Al Tamimi; Carlos A. Bagley; Salah G. Aoun

doi:10.1016/j.wneu.2023.03.037

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

Julia Yi, Matthew C. MacAllister, James P. Caruso, Paolo Palmisciano, Zachary D. Johnson, Giuseppe E. Umana, Mazin Al Tamimi, Carlos A. Bagley, Salah G. Aoun

Research output: Contribution to journal › Article › peer-review

Abstract

Background: Nontraumatic pedicle fracture is uncommon, with sparsely described cases of conservative management versus surgical treatment by open fusion or percutaneous fixation. Methods: 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. Results: The treatment led to fracture healing with good radiographic result and resolution of her symptoms. Conclusions: 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.

Original language	English (US)
Pages (from-to)	132-136
Number of pages	5
Journal	World neurosurgery
Volume	174
DOIs	https://doi.org/10.1016/j.wneu.2023.03.037
State	Published - Jun 2023

Keywords

Minimally invasive
Pedicle fracture
Pedicle screw
Spine

ASJC Scopus subject areas

Surgery
Clinical Neurology

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10.1016/j.wneu.2023.03.037

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@article{674673bbdc344fe9857b594b88179f67,

title = "Image-Guided Percutaneous Multilevel Pediculosynthesis for Treatment of Contiguous Pedicle Stress Fractures: Technical Case Report",

abstract = "Background: Nontraumatic pedicle fracture is uncommon, with sparsely described cases of conservative management versus surgical treatment by open fusion or percutaneous fixation. Methods: 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. Results: The treatment led to fracture healing with good radiographic result and resolution of her symptoms. Conclusions: 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.",

keywords = "Minimally invasive, Pedicle fracture, Pedicle screw, Spine",

author = "Julia Yi and MacAllister, {Matthew C.} and Caruso, {James P.} and Paolo Palmisciano and Johnson, {Zachary D.} and Umana, {Giuseppe E.} and {Al Tamimi}, Mazin and Bagley, {Carlos A.} and Aoun, {Salah G.}",

note = "Publisher Copyright: {\textcopyright} 2023 Elsevier Inc.",

year = "2023",

month = jun,

doi = "10.1016/j.wneu.2023.03.037",

language = "English (US)",

volume = "174",

pages = "132--136",

journal = "World neurosurgery",

issn = "1878-8750",

publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - Image-Guided Percutaneous Multilevel Pediculosynthesis for Treatment of Contiguous Pedicle Stress Fractures

T2 - Technical Case Report

AU - Yi, Julia

AU - MacAllister, Matthew C.

AU - Caruso, James P.

AU - Palmisciano, Paolo

AU - Johnson, Zachary D.

AU - Umana, Giuseppe E.

AU - Al Tamimi, Mazin

AU - Bagley, Carlos A.

AU - Aoun, Salah G.

PY - 2023/6

Y1 - 2023/6

N2 - Background: Nontraumatic pedicle fracture is uncommon, with sparsely described cases of conservative management versus surgical treatment by open fusion or percutaneous fixation. Methods: 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. Results: The treatment led to fracture healing with good radiographic result and resolution of her symptoms. Conclusions: 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.

AB - Background: Nontraumatic pedicle fracture is uncommon, with sparsely described cases of conservative management versus surgical treatment by open fusion or percutaneous fixation. Methods: 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. Results: The treatment led to fracture healing with good radiographic result and resolution of her symptoms. Conclusions: 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.

KW - Minimally invasive

KW - Pedicle fracture

KW - Pedicle screw

KW - Spine

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SN - 1878-8750

VL - 174

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JO - World neurosurgery

JF - World neurosurgery

ER -

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

Abstract

Keywords

ASJC Scopus subject areas

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