• World Neurosurg · Jun 2023

    Case Reports

    Image-Guided Percutaneous Multilevel Pediculosynthesis for the Treatment of Contiguous Pedicle Stress Fractures: A Technical Case Report Motion-Preserving Treatment of Contiguous Lumbar Pedicle Stress Fractures: A Technical Surgical Report.

    • Julia Yi, Matthew C MacAllister, James P Caruso, Paolo Palmisciano, Zachary D Johnson, Giuseppe E Umana, Al TamimiMazinMDepartment of Neurosurgery, University of Texas Southwestern, Dallas, Texas, USA., Carlos A Bagley, and Salah G Aoun.
    • Department of Neurosurgery, University of Texas Southwestern, Dallas, Texas, USA. Electronic address: juliayi28@gmail.com.
    • World Neurosurg. 2023 Jun 1; 174: 132136132-136.

    BackgroundNontraumatic pedicle fracture is uncommon, with sparsely described cases of conservative management versus surgical treatment by open fusion or percutaneous fixation.MethodsWe 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.ResultsThe treatment led to fracture healing with good radiographic result and resolution of her symptoms.ConclusionsA 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.Copyright © 2023 Elsevier Inc. All rights reserved.

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