title: Chance fracture after pedicle screw fixation. A case report.
abstract: METHODS
  A case of a Chance fracture through an instrumented pedicle is presented. The radiographic and intraoperative findings and management of this complication are reported.
  
  
  OBJECTIVE
  To increase awareness of the complications of transpedicular screw fixation and to suggest a form of management of this unusual complication.
  
  
  BACKGROUND
  To the authors' knowledge, this is the first reported case of such a vertebral fracture occurring after pedicle screw fixation.
  
  
  METHODS
  A 44-year-old man with athetoid cerebral palsy and a progressive thoracic kyphosis sustained a Chance fracture at the caudal end of the segmental instrumentation construct.
  
  
  RESULTS
  Surgical intervention, including fracture reduction and extension of the instrumented fusion to the pelvis, provided effective restoration of physiologic sagittal alignment.
  
  
  CONCLUSIONS
  Chance fracture after pedicle screw fixation can be successfully managed with surgical intervention.
authors.affiliation: Department of Orthopedics, Hospital for Special Surgery, Cornell University Medical Center, New York, New York, USA.
authors.forename: D S
authors.initials: DS
authors.lastname: Levine
authors.forename: J R
authors.initials: JR
authors.lastname: Dugas
authors.forename: S J
authors.initials: SJ
authors.lastname: Tarantino
authors.forename: O
authors.initials: O
authors.lastname: Boachie-Adjei
mesh_terms: D000328:Adult; D001863:Bone Screws / Q000009:adverse effects*; D002547:Cerebral Palsy / Q000150:complications; D006801:Humans; D016268:Internal Fixators / Q000009:adverse effects*; D007738:Kyphosis / Q000601:surgery; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D008297:Male; D011859:Radiography; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery