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首页> 外文期刊>Neurosurgery >Early sacral stress fracture after reduction of spondylolisthesis and lumbosacral fixation: case report.
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Early sacral stress fracture after reduction of spondylolisthesis and lumbosacral fixation: case report.

机译：减少腰椎滑脱和腰s固定后的早期骨应力性骨折：病例报告。

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OBJECTIVE AND IMPORTANCE: Early sacral fracture is an extremely rare complication of instrumented lumbosacral fusion seen in older, osteopenic women. Previous reports have attributed the problem to the use of multisegmental (three or more levels) fixation, with the transfer of stress forces from rigid spinal implants to the sacrum. We report the only case, to the best of our knowledge, of early sacral fracture after a two-level lumbosacral fusion and the only case of early sacral fracture after reduction of spondylolisthesis. CLINICAL PRESENTATION: A patient presented with a sudden recurrence of low back and buttock pain a few days after lumbosacral decompression, reduction of L5-S1 Grade II spondylolisthesis, and instrumented L5-S1 fusion, including posterior lumbar interbody fusion. A transverse sacral fracture was found on plain x-rays 4 weeks later. INTERVENTION: Symptoms improved with brace therapy and medical treatment for osteoporosis. CONCLUSION: Early sacral fracture is a rare cause of pain after instrumented lumbosacral fusion. Although the transfer of loads from rigid spinal implants to adjacent segments is particularly problematic for multisegmental fusions, patients with short-segment constructs may also be affected. Active reduction of spondylolisthesis may provide additional adjacent segment stress contributing to this complication.
机译：目的和重要性：Early骨早期骨折是在老年骨质疏松妇女中发生的腰融合器械异常罕见的并发症。先前的报道将问题归因于多节（三级或更多级）固定的使用，应力从刚性脊柱植入物转移到to骨。据我们所知，唯一的病例是两级腰s融合后的early骨早期骨折，而减少的是腰椎滑脱后的fracture骨早期骨折。临床表现：腰s减压，几天L5-S1Ⅱ级腰椎滑脱减少和经器械L5-S1融合（包括腰椎后椎体间融合）后几天出现腰背和臀部疼痛突然复发的患者。 4周后在平片上发现骨横骨骨折。干预：支架疗法和药物治疗骨质疏松症可改善症状。结论：经腰fusion融合治疗后，Early骨早期骨折是罕见的疼痛原因。尽管将载荷从刚性脊柱植入物转移到相邻节段对于多节段融合尤其有问题，但短节段构造的患者也可能受到影响。主动减少脊椎滑脱可能会增加额外的邻近节段应力，从而导致这种并发症。

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