Atypical Bilateral Pedicle Fracture in Long-Term Bisphosphonate Therapy

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Abstract

Study Design.

A case report with review of the literature.

Objective.

To present a first case of an atraumatic bilateral pedicle fracture of L5 in a patient with long-term risedronate therapy and without any previous history of surgery or fracture.

Summary of Background Data.

A few cases of bilateral osteoporotic pedicle fractures have been reported. All were associated with previous or concomitant corporeal compression fractures. Atypical femoral fractures were recently described with long-term bisphosphonate treatment. To our knowledge, there are no previous reports of isolated bilateral pedicle fracture associated with prolonged bisphosphonate therapy.

Methods.

A 66-year-old woman treated with risedronate for 10 years and without any history of trauma presented with exacerbation of low back pain. No fracture was noted in her past medical history.

Results.

A complete workup showed an isolated bilateral recent fracture of the L5 pedicles without evident etiology. Consolidation was achieved after 3 months of bracing.

Conclusion.

We reported the first case of isolated bilateral pedicle fracture in a patient treated with risedronate for 10 years. This may be another atypical fracture in long-term bisphosphonate treatment.

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