Bilateral lumbar pedicle fracture in a patient receiving long-term bisphosphonate therapy: a case report with pathological evaluation

IF 3.1 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Archives of Osteoporosis Pub Date : 2024-10-24 DOI:10.1007/s11657-024-01462-8

Ryo Fujita, Kota Suda, Zen-Ichi Tanei, Satoko Matsumoto Harmon, Miki Komatsu, Keiichi Nakai, Kento Inomata, Shin Matsushima, Tsutomu Endo, Katsuhisa Yamada, Masahiko Takahata, Norimasa Iwasaki

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Abstract

Background

Bilateral pedicle fractures of the lumbar spine are uncommon and are typically associated with strenuous activities, traumatic events, or previous spinal surgery. This study reported a case of bilateral pedicle fracture in a patient with a long history of osteoporosis treatment with bisphosphonate and included a histological evaluation of the bone.

Case presentation

An 82-year-old woman with no history of trauma presented to our hospital with back pain that had worsened over the previous month. Computed tomography and magnetic resonance imaging revealed bilateral pedicle fractures of the third lumbar vertebra. She had osteoporosis and had been taking bisphosphonates for 9 years. The patient underwent posterior lumbar fusion, and her symptoms improved. Bone biopsy results from the spinous process revealed few osteoblasts and an absence of osteoclasts, indicating low bone turnover.

Conclusions

Long-term use of bisphosphonates may contribute to the development of atypical bilateral pedicle fractures in patients with osteoporosis.

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一名长期接受双膦酸盐治疗的患者双侧腰椎椎弓根骨折：病例报告及病理评估。

背景：腰椎双侧椎弓根骨折并不常见，通常与剧烈活动、创伤事件或既往脊柱手术有关。本研究报告了一例双侧椎弓根骨折病例，患者长期使用双膦酸盐治疗骨质疏松症，并对骨组织进行了评估：一名 82 岁的妇女因背痛而到我院就诊，她没有外伤史，且背痛在过去一个月中不断加剧。计算机断层扫描和磁共振成像显示，第三腰椎的双侧椎弓根骨折。她患有骨质疏松症，服用双磷酸盐药物已有9年。患者接受了腰椎后路融合术，症状有所改善。脊柱棘突的骨活检结果显示，成骨细胞很少，破骨细胞缺失，表明骨转换率低：结论：长期服用双磷酸盐类药物可能会导致骨质疏松症患者发生非典型双侧椎弓根骨折。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Archives of Osteoporosis ENDOCRINOLOGY & METABOLISMORTHOPEDICS -ORTHOPEDICS

CiteScore

5.50

自引率

10.00%

发文量

133

期刊介绍： Archives of Osteoporosis is an international multidisciplinary journal which is a joint initiative of the International Osteoporosis Foundation and the National Osteoporosis Foundation of the USA. The journal will highlight the specificities of different regions around the world concerning epidemiology, reference values for bone density and bone metabolism, as well as clinical aspects of osteoporosis and other bone diseases.