Minimally Traumatic Spinopelvic Dissociation With Prolonged Bisphosphonate Use

Bisphosphonates have become the first-line treatment for diseases involving excessive osteoclast-mediated bone resorption. However, evidence suggests that elevated doses or prolonged treatment may impair normal skeletal mineralization and may be associated with fractures. The majority of these fractures are located in the subtrochanteric region. This article presents the first described case of atraumatic spinopelvic dissociation related to a combination of osteoporosis and prolonged bisphosphonate use. The current literature also is reviewed, and putative mechanisms and management options are discussed. [Orthopedics. 2016; 39(4):e753-e755.].