Bilateral fracture of L5 pedicles in a patient with total disc replacement of L5-S1: a case report
Report of a rare complication - fracture of the pedicles - in a patient with total disc replacement of L5-S1, a surgical resolution, and a biomechanical explanation. To the authors' knowledge, there is only one previous report of bilateral fracture of the pedicles in the literature, as a compli...
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Sociedade Brasileira de Coluna (SBC)
2014-01-01
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doaj-b4da69d3cd974c899d9f80470554e3522020-11-24T22:42:43ZengSociedade Brasileira de Coluna (SBC)Coluna/Columna 2177-014X2014-01-0113215315510.1590/S1808-18512014130200456S1808-18512014000200153Bilateral fracture of L5 pedicles in a patient with total disc replacement of L5-S1: a case reportJorge Alberto De Haro EstradaJavier Ramos FernandezJuan Carlos Alvarez GarnierMichael Dittmar JohnsonFrancisco Cruz LopezReport of a rare complication - fracture of the pedicles - in a patient with total disc replacement of L5-S1, a surgical resolution, and a biomechanical explanation. To the authors' knowledge, there is only one previous report of bilateral fracture of the pedicles in the literature, as a complication in total disc replacement of the lumbar spine. In this case, no direct repair was made to the fracture site; instead intersomatic fusion was performed by the anterior approach. A 40-year-old male, a martial arts practitioner who had undergone L5-S1 (ProDisc(r)) disc replacement nine months earlier, with complete resolution of the preoperative symptoms and no complications, sudden pain during physical activity, without neurological symptoms. Computed axial tomography showed a fracture of the L5 pedicles and anterior luxation of the polyethylene insert. Surgery was performed by the posterior approach, with direct repair of the fractures and posterolateral fusion of L5-S1 with transpedicular screws (Schanz) and USS(r) internal fixator. A follow-up axial CT scan at 6 months after surgery showed complete consolidation of the fractures, and the patient was asymptomatic. Due to the alteration in weight transmission through the anterior part of the spine in the total replacement of the lumbar disc, which preserves the movement but not the absorption of forces, the pedicle becomes more susceptible to fracture. It is important to bear this complication in patients submitted to this procedure.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1808-18512014000200153&lng=en&tlng=enDisco intervertebralColumna vertebralFusión vertebralTornillos óseos |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jorge Alberto De Haro Estrada Javier Ramos Fernandez Juan Carlos Alvarez Garnier Michael Dittmar Johnson Francisco Cruz Lopez |
spellingShingle |
Jorge Alberto De Haro Estrada Javier Ramos Fernandez Juan Carlos Alvarez Garnier Michael Dittmar Johnson Francisco Cruz Lopez Bilateral fracture of L5 pedicles in a patient with total disc replacement of L5-S1: a case report Coluna/Columna Disco intervertebral Columna vertebral Fusión vertebral Tornillos óseos |
author_facet |
Jorge Alberto De Haro Estrada Javier Ramos Fernandez Juan Carlos Alvarez Garnier Michael Dittmar Johnson Francisco Cruz Lopez |
author_sort |
Jorge Alberto De Haro Estrada |
title |
Bilateral fracture of L5 pedicles in a patient with total disc replacement of L5-S1: a case report |
title_short |
Bilateral fracture of L5 pedicles in a patient with total disc replacement of L5-S1: a case report |
title_full |
Bilateral fracture of L5 pedicles in a patient with total disc replacement of L5-S1: a case report |
title_fullStr |
Bilateral fracture of L5 pedicles in a patient with total disc replacement of L5-S1: a case report |
title_full_unstemmed |
Bilateral fracture of L5 pedicles in a patient with total disc replacement of L5-S1: a case report |
title_sort |
bilateral fracture of l5 pedicles in a patient with total disc replacement of l5-s1: a case report |
publisher |
Sociedade Brasileira de Coluna (SBC) |
series |
Coluna/Columna |
issn |
2177-014X |
publishDate |
2014-01-01 |
description |
Report of a rare complication - fracture of the pedicles - in a patient with total disc replacement of L5-S1, a surgical resolution, and a biomechanical explanation. To the authors' knowledge, there is only one previous report of bilateral fracture of the pedicles in the literature, as a complication in total disc replacement of the lumbar spine. In this case, no direct repair was made to the fracture site; instead intersomatic fusion was performed by the anterior approach. A 40-year-old male, a martial arts practitioner who had undergone L5-S1 (ProDisc(r)) disc replacement nine months earlier, with complete resolution of the preoperative symptoms and no complications, sudden pain during physical activity, without neurological symptoms. Computed axial tomography showed a fracture of the L5 pedicles and anterior luxation of the polyethylene insert. Surgery was performed by the posterior approach, with direct repair of the fractures and posterolateral fusion of L5-S1 with transpedicular screws (Schanz) and USS(r) internal fixator. A follow-up axial CT scan at 6 months after surgery showed complete consolidation of the fractures, and the patient was asymptomatic. Due to the alteration in weight transmission through the anterior part of the spine in the total replacement of the lumbar disc, which preserves the movement but not the absorption of forces, the pedicle becomes more susceptible to fracture. It is important to bear this complication in patients submitted to this procedure. |
topic |
Disco intervertebral Columna vertebral Fusión vertebral Tornillos óseos |
url |
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1808-18512014000200153&lng=en&tlng=en |
work_keys_str_mv |
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