A bony Chance fracture through L1 following posterior spinal fusion for adolescent idiopathic scoliosis: a case report.

dc.contributor.author

Rocos, Brett

dc.contributor.author

Kato, So

dc.contributor.author

Lebel, David

dc.contributor.author

Lewis, Stephen

dc.date.accessioned

2024-01-10T16:18:17Z

dc.date.available

2024-01-10T16:18:17Z

dc.date.issued

2021-05

dc.description.abstract

Study design

Case report.

Introduction

Instrumented posterior fusion using pedicle screws has been the mainstay of the surgical correction of adolescent idiopathic scoliosis since it was popularised by Roy-Camille in the 1970s. The aim of this case report is to describe the occurrence and salvage of an L1 chance fracture occurring through the lower instrumented vertebra following pedicle screw placement for posterior spinal instrumented fusion in the treatment of adolescent idiopathic scoliosis (AIS).

Case report

A 15-year-old female patient underwent T2-L1 posterior instrumented fusion for a Lenke 1b deformity. The selection of fusion levels was made based upon standing and bending radiographs which showed a non-structural lumbar curve. Early recovery was uneventful. At 6 months post-operatively, the patient reported new deformity and pain. A chance fracture at L1 was diagnosed and subsequent extension of instrumentation to L3 was carried out. Final post-operative recovery was uneventful and the patient returned to an active lifestyle.

Conclusion

Several factors can contribute to the occurrence of a fracture through an instrumented pedicle. This case shows that there must be due consideration of the small pedicle at L1 when it is chosen as the LIV.
dc.identifier

10.1007/s43390-020-00257-4

dc.identifier.issn

2212-134X

dc.identifier.issn

2212-1358

dc.identifier.uri

https://hdl.handle.net/10161/29699

dc.language

eng

dc.publisher

Springer Science and Business Media LLC

dc.relation.ispartof

Spine deformity

dc.relation.isversionof

10.1007/s43390-020-00257-4

dc.rights.uri

https://creativecommons.org/licenses/by-nc/4.0

dc.subject

Thoracic Vertebrae

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Humans

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Scoliosis

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Treatment Outcome

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Spinal Fusion

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Adolescent

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Female

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Pedicle Screws

dc.title

A bony Chance fracture through L1 following posterior spinal fusion for adolescent idiopathic scoliosis: a case report.

dc.type

Journal article

duke.contributor.orcid

Rocos, Brett|0000-0002-0808-5585

pubs.begin-page

859

pubs.end-page

862

pubs.issue

3

pubs.organisational-group

Duke

pubs.organisational-group

School of Medicine

pubs.organisational-group

Clinical Science Departments

pubs.organisational-group

Orthopaedic Surgery

pubs.organisational-group

Neurosurgery

pubs.publication-status

Published

pubs.volume

9

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