Stress fracture of the lumbar pedicle bilaterally: surgical repair using a percutaneous minimally invasive technique.

Bilateral pedicle fractures in the spine are uncommon in the absence of bony abnormality, previous surgery, or trauma. The authors report a case of spontaneous bilateral lumbar pedicle fracture in a 50-year-old sedentary woman, which caused intractable pain and did not respond to months of conservative management. The fractures were surgically treated using a percutaneous, minimally invasive technique with screws placed directly through the fractures into the vertebral body. The pedicles were strategically tapped to achieve the lag effect and reapproximate the posterior fragment with the anterior elements. The patient tolerated the procedure well and experienced early improvement of her symptoms, and follow-up imaging showed evidence of fracture healing. Transpedicular fixation and the use of the lag effect could be a useful strategy in the treatment of future cases involving poorly healing pedicle fractures causing persistent symptoms.