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Chance fracture after pedicle screw fixation. A case report
D S Levine1, J R Dugas, S J Tarantino
1Department of Orthopedics, Hospital for Special Surgery, Cornell University Medical Center, New York, New York, USA.
Spine
|March 21, 1998
Summary
This case report details a rare Chance fracture occurring after pedicle screw fixation. Surgical management effectively restored spinal alignment, highlighting a viable treatment option for this complication.
Area of Science:
- Spinal surgery
- Orthopedic complications
- Vertebral fractures
Background:
- Transpedicular screw fixation is a common spinal stabilization technique.
- Complications, though rare, can arise from spinal instrumentation.
- Awareness of potential adverse events is crucial for patient safety.
Observation:
- A 44-year-old male with athetoid cerebral palsy and progressive thoracic kyphosis developed a Chance fracture.
- The fracture occurred at the caudal end of a segmental instrumentation construct.
- This represents the first reported instance of a Chance fracture post-pedicle screw fixation.
Findings:
- Radiographic and intraoperative findings confirmed the Chance fracture.
- Surgical intervention involved fracture reduction and extended instrumented fusion to the pelvis.
- This management successfully restored physiologic sagittal alignment.
Implications:
- This case highlights an unusual complication of transpedicular screw fixation.
- Successful surgical management suggests a potential treatment pathway for similar cases.
- Increased awareness can aid surgeons in recognizing and managing this rare fracture pattern.