Atypical lumbar pedicle fractures. A case report and comparative review of the literature: Bisphosphonate-related? Possible matching with diagnostic criteria of atypical fractures of the femur
Introduction: Bisphosphonates are commonly used to prevent osteoporotic fractures. Many randomized controlled trials have proved the efficacy of bisphosphonates, showing their ability to increase bone mineral density and decrease the risk of hip and vertebral fractures. Atypical, bisphosphonate-rela...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2024-01-01
|
| Series: | Brain and Spine |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772529424000420 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850257633924087808 |
|---|---|
| author | Emmanouil Theodorakis Georgios Touloupakis Guido Antonini Maria Gabriella Lettera Marco Teli |
| author_facet | Emmanouil Theodorakis Georgios Touloupakis Guido Antonini Maria Gabriella Lettera Marco Teli |
| author_sort | Emmanouil Theodorakis |
| collection | DOAJ |
| description | Introduction: Bisphosphonates are commonly used to prevent osteoporotic fractures. Many randomized controlled trials have proved the efficacy of bisphosphonates, showing their ability to increase bone mineral density and decrease the risk of hip and vertebral fractures. Atypical, bisphosphonate-related fractures concerning the femur have been widely described and a list of primary and secondary clinical and radiographic criteria are used in order to achieve diagnosis. Research question: To identify clinical and radiographic findings for a possible association of vertebral fractures to prolonged bisphosphonate therapy. Material and methods: In this paper we present a case of an atraumatic bilateral pedicle lumbar fracture, assuming the hypothesis of an insufficiency atypical fracture due to prolonged Alendronate therapy for osteoporosis. We highlight the various aspects for diagnosis, treatment and a review of the existing literature was carried out. Discussion and conclusion: Atypical fractures in the spine are rarely reported in the literature. Pedicle anatomy is partially similar to a long bone, described as a strong bridge between the posterior arch and the vertebral body composed of a cortical bone and a cancellous core. Stress fractures are reported as a result of an underlying bone disease, trauma, post-surgery and stress fractures. In our opinion, the criteria described for atypical femoral fractures are a useful tool to also classify these rare pedicle lesions as insufficiency, bisphosphonate-correlated fractures. |
| format | Article |
| id | doaj-art-4666e66c740d413cb0d91db787a5b70f |
| institution | OA Journals |
| issn | 2772-5294 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brain and Spine |
| spelling | doaj-art-4666e66c740d413cb0d91db787a5b70f2025-08-20T01:56:20ZengElsevierBrain and Spine2772-52942024-01-01410278610.1016/j.bas.2024.102786Atypical lumbar pedicle fractures. A case report and comparative review of the literature: Bisphosphonate-related? Possible matching with diagnostic criteria of atypical fractures of the femurEmmanouil Theodorakis0Georgios Touloupakis1Guido Antonini2Maria Gabriella Lettera3Marco Teli4Corresponding author.; Consultant Orthopaedic Surgeon, San Carlo Borromeo Hospital, Via Pio II 3, Milano, ItalyConsultant Orthopaedic Surgeon, San Carlo Borromeo Hospital, Via Pio II 3, Milano, ItalyConsultant Orthopaedic Surgeon, San Carlo Borromeo Hospital, Via Pio II 3, Milano, ItalyConsultant Orthopaedic Surgeon, San Carlo Borromeo Hospital, Via Pio II 3, Milano, ItalyConsultant Orthopaedic Surgeon, San Carlo Borromeo Hospital, Via Pio II 3, Milano, ItalyIntroduction: Bisphosphonates are commonly used to prevent osteoporotic fractures. Many randomized controlled trials have proved the efficacy of bisphosphonates, showing their ability to increase bone mineral density and decrease the risk of hip and vertebral fractures. Atypical, bisphosphonate-related fractures concerning the femur have been widely described and a list of primary and secondary clinical and radiographic criteria are used in order to achieve diagnosis. Research question: To identify clinical and radiographic findings for a possible association of vertebral fractures to prolonged bisphosphonate therapy. Material and methods: In this paper we present a case of an atraumatic bilateral pedicle lumbar fracture, assuming the hypothesis of an insufficiency atypical fracture due to prolonged Alendronate therapy for osteoporosis. We highlight the various aspects for diagnosis, treatment and a review of the existing literature was carried out. Discussion and conclusion: Atypical fractures in the spine are rarely reported in the literature. Pedicle anatomy is partially similar to a long bone, described as a strong bridge between the posterior arch and the vertebral body composed of a cortical bone and a cancellous core. Stress fractures are reported as a result of an underlying bone disease, trauma, post-surgery and stress fractures. In our opinion, the criteria described for atypical femoral fractures are a useful tool to also classify these rare pedicle lesions as insufficiency, bisphosphonate-correlated fractures.http://www.sciencedirect.com/science/article/pii/S2772529424000420Lumbar fractureAtypicalBisphosphonatePercutaneous fixation |
| spellingShingle | Emmanouil Theodorakis Georgios Touloupakis Guido Antonini Maria Gabriella Lettera Marco Teli Atypical lumbar pedicle fractures. A case report and comparative review of the literature: Bisphosphonate-related? Possible matching with diagnostic criteria of atypical fractures of the femur Brain and Spine Lumbar fracture Atypical Bisphosphonate Percutaneous fixation |
| title | Atypical lumbar pedicle fractures. A case report and comparative review of the literature: Bisphosphonate-related? Possible matching with diagnostic criteria of atypical fractures of the femur |
| title_full | Atypical lumbar pedicle fractures. A case report and comparative review of the literature: Bisphosphonate-related? Possible matching with diagnostic criteria of atypical fractures of the femur |
| title_fullStr | Atypical lumbar pedicle fractures. A case report and comparative review of the literature: Bisphosphonate-related? Possible matching with diagnostic criteria of atypical fractures of the femur |
| title_full_unstemmed | Atypical lumbar pedicle fractures. A case report and comparative review of the literature: Bisphosphonate-related? Possible matching with diagnostic criteria of atypical fractures of the femur |
| title_short | Atypical lumbar pedicle fractures. A case report and comparative review of the literature: Bisphosphonate-related? Possible matching with diagnostic criteria of atypical fractures of the femur |
| title_sort | atypical lumbar pedicle fractures a case report and comparative review of the literature bisphosphonate related possible matching with diagnostic criteria of atypical fractures of the femur |
| topic | Lumbar fracture Atypical Bisphosphonate Percutaneous fixation |
| url | http://www.sciencedirect.com/science/article/pii/S2772529424000420 |
| work_keys_str_mv | AT emmanouiltheodorakis atypicallumbarpediclefracturesacasereportandcomparativereviewoftheliteraturebisphosphonaterelatedpossiblematchingwithdiagnosticcriteriaofatypicalfracturesofthefemur AT georgiostouloupakis atypicallumbarpediclefracturesacasereportandcomparativereviewoftheliteraturebisphosphonaterelatedpossiblematchingwithdiagnosticcriteriaofatypicalfracturesofthefemur AT guidoantonini atypicallumbarpediclefracturesacasereportandcomparativereviewoftheliteraturebisphosphonaterelatedpossiblematchingwithdiagnosticcriteriaofatypicalfracturesofthefemur AT mariagabriellalettera atypicallumbarpediclefracturesacasereportandcomparativereviewoftheliteraturebisphosphonaterelatedpossiblematchingwithdiagnosticcriteriaofatypicalfracturesofthefemur AT marcoteli atypicallumbarpediclefracturesacasereportandcomparativereviewoftheliteraturebisphosphonaterelatedpossiblematchingwithdiagnosticcriteriaofatypicalfracturesofthefemur |