Spine Service, Department of Orthopaedic Surgery, St. George Hospital and Clinical School, University of New South Wales, 53 Montgomery Street, Kogarah-2217, NSW, Australia.
Spine (Phila Pa 1976). 2010 Apr 15;35(8):E311-5. doi: 10.1097/BRS.0b013e3181c39082.
Single case report.
To report the observation of multiple lumbar pedicle fractures in a patient with osteopetrosis.
Osteopetrosis is characterized by osteoclast dysfunction, impaired bone resorption, and poor bone remodeling. As a result, the bone is brittle but hard and is referred to as "marble bone disease." Although long bone fractures are relatively common, fractures of the spine are rare. Spondylolysis has been reported in the cervical and lumbar spine, and pedicle fractures have been reported in the cervical spine. We report the case of a patient with autosomal dominant osteopetrosis with multiple lumbar pedicle fractures. To the best of our knowledge, there have been no previous reports of multiple lumbar pedicle fractures in osteopetrosis.
A 73-year-old woman, with a known history of osteopetrosis, presented with acute nonradiating low back pain following a bout of coughing. The lower limb neurology and bladder and bowel function were normal. The imaging findings, clinical course, and treatment are discussed.
Initial computed tomography scans of the patient revealed the presence of multiple pedicle fractures with spondylolysis. The patient was advised bed rest for the first 3 days, and when the acute pain subsided, she was permitted to ambulate with a lumbosacral corset. The patient was asymptomatic for 8 months, when she was readmitted with another episode of acute low back pain. The CT scan revealed fresh fracture of the L4 pedicle, which was not seen on the previous scan. The pain settled down again with conservative measures.
This case report discusses the rare occurrence of multiple lumbar pedicle fractures and pars interarticularis (spondylolysis) fractures in a patient with osteopetrosis.
单病例报告。
报告一例成骨不全症患者出现多处腰椎椎弓根骨折的观察结果。
成骨不全症的特征为破骨细胞功能障碍、骨吸收受损和骨重塑不良。结果，骨骼脆弱但坚硬，被称为“大理石骨病”。尽管长骨骨折较为常见，但脊柱骨折较为罕见。颈椎和腰椎已报道有脊椎裂，颈椎已报道有椎弓根骨折。我们报告一例常染色体显性遗传性成骨不全症伴多处腰椎椎弓根骨折的病例。据我们所知，此前尚未有关于成骨不全症多处腰椎椎弓根骨折的报道。
一名 73 岁女性，已知患有成骨不全症，在一次咳嗽后出现急性非放射性腰痛。下肢神经和膀胱及肠道功能正常。讨论了影像学表现、临床经过和治疗。
患者的初始 CT 扫描显示存在多处椎弓根骨折伴脊椎裂。建议患者卧床休息 3 天，急性疼痛缓解后，允许其佩戴腰骶部束带行走。8 个月后患者无症状，再次因急性腰痛入院。CT 扫描显示 L4 椎弓根有新鲜骨折，而前一次扫描未见。疼痛再次通过保守治疗得到缓解。
本病例报告讨论了一例成骨不全症患者罕见的多处腰椎椎弓根骨折和椎弓根峡部（脊椎裂）骨折的发生。
