Contralateral Spondylolysis and Fracture of the Lumbar Pedicle in an Elite Female Gymnast

Guillodo, Y.; Botton, Estelle; Saraux, Alain; Goff, P. Le

doi:10.1097/00007632-200010010-00019

Cited by 53 publications

(50 citation statements)

References 9 publications

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“…In most published cases, patients have undergone surgery either immediately or after an immobilization failure [10]. Despite the case of a spontaneous healing of the pedicle fracture without immobilization in a young gymnast female reported by Guillodo et al [5], we stress the importance of an effective lumbosacral junction immobilization, by means of a modified brace incorporating one thigh, to avoid L5 pedicle non union. We think that, especially in young patients before skeletal maturity, conservative treatment should be considered as a treatment option for this unusual injury.…”

Section: Discussionmentioning

confidence: 82%

“…Unilateral spondylolysis associated with sclerosis and hypertrophy of the contralateral side of the neural arch is well described in the literature [1][2][3][4][5][6][7][8]10]. Pedicle fractures also occurred following contralateral isthmic spondylolysis, secondary to a weakening of the neural arch with resulting increased stress across the contralateral pedicle [1,2,4].…”

Section: Discussionmentioning

confidence: 99%

“…Pedicle fractures also occurred following contralateral isthmic spondylolysis, secondary to a weakening of the neural arch with resulting increased stress across the contralateral pedicle [1,2,4]. Unilateral spondylolysis associated with pedicular fracture has been described in competitive sport patients [2,5,10]. To explain pedicular fracture, authors usually insist on the asymmetric character of sports activities, requiring rotary movements.…”

Section: Discussionmentioning

confidence: 99%

“…Stress fracture of the vertebral pedicle in the lumbar spine associated with contralateral spondylolysis are already described in the literature [1][2][3][4][5][6][7][8]10], especially in competitive sport patients. This lesion has not been described previously during childhood.…”

Section: Introductionmentioning

confidence: 97%

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Acute L5 pedicle fracture and contralateral spondylolysis in a 12-year-old boy: a case report

Vialle¹,

Mary²,

Carvalho³

et al. 2007

Eur Spine J

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Acute unilateral L5 pedicle fracture associated with a pre-existing contralateral spondylolysis is a rare lesion. We report a case in a non-competitive 12-year-old boy. We present the clinical, radiological and specific management of this rare condition. The clinical and radiological draft of this patient was reviewed. The followup was 30 months after fracture healing. Some cases reported in the literature were analyzed and our clinical findings and therapeutic strategy was compared and discussed. Non-operative treatment was done including fulltime bracing in a modified Boston brace incorporating one thigh for 3 months. Plain radiographs and computed tomographic (CT)-scan performed at 3 and 6 months showed progressive healing of the pedicle fracture and no modification of the contralateral isthmic spondylolytic lesion. At final follow-up, the patient was asymptomatic and resumed all his activities. In skeletally immature patients, we think that conservative treatment should be considered as a treatment option for this unusual injury.

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Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

See 2 more Smart Citations

Acute L5 pedicle fracture and contralateral spondylolysis in a 12-year-old boy: a case report

Vialle¹,

Mary²,

Carvalho³

et al. 2007

Eur Spine J

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show abstract

“…These fractures may occur bilaterally or on the contralateral side in patients with unilateral spondylolysis [1,2,6,7,12]. Bilateral pedicle fracture is a rare entity.…”

Section: Discussionmentioning

confidence: 99%

Bilateral pedicle stress fracture in a patient with osteoporotic compression fracture

et al. 2008

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A case of bilateral pedicle stress fracture of L4 in a patient with osteoporotic compression fracture of L5 and without a history of major trauma or surgery is reported, and the literature is reviewed. Bilateral pedicle fracture is a rare entity and few cases have been reported in the literature. All reported cases had some underlying causative factors like previous spine surgery or stress related activities. To the best of the authors' knowledge, only one case of bilateral pedicle stress fracture without a history of trauma, previous spine surgery, or stress-related activities has been reported. A 77-year-old woman presented with severe low back pain and radiating pain in the right leg that was exacerbated after standing and walking. Plain radiograph showed pathological fracture at L5 level. Magnetic resonance imaging (MRI) revealed the compression of dural sac at L5 level. CT scan taken 3 months after admission revealed bilateral pedicle fractures through L4. The patient was treated with decompressive laminectomies of L4, followed by posterior spinal fusion with rigid pedicle screw fixation and autogenous bone graft mixed with hydroxyapatite. The patient achieved pain relief and returned to normal activity. Stress fracture of the pedicle within the proximal vertebra of an osteoporotic compression fracture of lumbar spine is an uncommon entity. It may, however, be an additional source of symptoms in patients with osteoporosis who present with further back pain. Surgeons caring for this group of patients should be aware of this condition.

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Lower Back Injuries

Cooper

Herrera

Dambeck

2008

Essential Sports Medicine

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Contralateral Spondylolysis and Fracture of the Lumbar Pedicle in an Elite Female Gymnast

Abstract: Inconsistency between radiographs and clinical observations can be noted, and spontaneous consolidation of pedicular fractures can occur despite the practice of the gymnastics 15 hours a week.

Cited by 53 publications

References 9 publications

Acute L5 pedicle fracture and contralateral spondylolysis in a 12-year-old boy: a case report

Acute L5 pedicle fracture and contralateral spondylolysis in a 12-year-old boy: a case report

Bilateral pedicle stress fracture in a patient with osteoporotic compression fracture

Lower Back Injuries

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