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C6 Pedicle Fatigue Fracture Nonunion Causing Unilateral Cervical Radiculopathy Through Hypertrophic Foraminal
Sho Hineno1, Takafumi Murakami1, Eiji Wada1,2
1Department of Orthopaedic Surgery and Spine Surgery, Matsuyama Madonna Hospital, Matsuyama, Japan.
Case:
A 56-year-old woman presented with progressive weakness of the left shoulder abduction and elbow flexion. She had cervical dystonia. Imaging revealed bilateral chronic C6 pedicle fatigue fracture nonunion, with left hypertrophic changes causing C5 to 6 foraminal stenosis and C5 to C6 radiculopathy. Posterior C4 to C7 fixation with left foraminotomies was performed. Motor function improved, and follow-up computed tomography (CT) confirmed healing of the nonunion.
Conclusion:
Cervical pedicle fatigue fracture nonunion is a rare but underrecognized cause of radiculopathy when hypertrophic changes cause foraminal stenosis. CT with multiplanar reconstruction is essential, and combined stabilization and decompression can achieve excellent motor recovery.
