Chung Kook Jin, Hwang Yoon Sub, Koh Sung Hye
Department of Orthopaedic Surgery, Kangnam Sacred Heart Hospital, Hallym University, Seoul, Korea.
Spine (Phila Pa 1976). 2009 May 1;34(10):E380-3. doi: 10.1097/BRS.0b013e31819fd3a0.
A case report of stress fracture of bilateral lumbar posterior facet after implantation of interspinous process device is reported and the literature reviewed. OBJECTIVE.: To report the rare case of stress fracture of bilateral lumbar posterior facet after implantation of interspinous process device.
A 64-year-old woman presented with severe back pain and radiating pain in both legs. In her history, she had undergone implantation of L4-L5 interspinous process device (Coflex, Paradigm Spine, Wurmlingen, Germany) for her neurogenic claudication at 6 years ago. Magnetic resonance image demonstrated signal change suggesting bilateral L4 inferior process. To the best of the authors' knowledge, there has been no report stress fracture of posterior facet after implantation of interspinous process device.
This study reviewed the patient's medical record, her imaging studies, and related literatures.
In the reported case, stress fracture of bilateral posterior facet was documented with MRI and confirmed with surgical treatment for the surgical treatment of spinal stenosis. The involved facet joint was at the site affected by previously implanted interspinous process device.
Posterior facet fracture can occur as a complication of interspinous process device.
报告一例棘突间植入装置植入后双侧腰椎小关节应力性骨折的病例报告并复习相关文献。目的:报告棘突间植入装置植入后双侧腰椎小关节应力性骨折的罕见病例。
一名64岁女性,出现严重背痛及双下肢放射痛。既往史显示,6年前她因神经源性间歇性跛行接受了L4-L5棘突间植入装置(德国乌尔姆林根Paradigm Spine公司的Coflex)植入术。磁共振成像显示信号改变,提示双侧L4下关节突病变。据作者所知,尚无棘突间植入装置植入后小关节应力性骨折的报告。
本研究回顾了患者的病历、影像学检查及相关文献。
在该报告病例中,MRI证实双侧小关节应力性骨折,并通过手术治疗腰椎管狭窄症得以确认。受累小关节位于先前植入棘突间植入装置的部位。
小关节骨折可能作为棘突间植入装置的一种并发症出现。