title: Fractures of the lumbar and sacral superior articular processes: report of two cases.
abstract: OBJECTIVE
  Injury to the posterior vertebral elements of the lumbar spine represents a common cause of lower back pain in athletes. However, associations between nontraumatic fracture, nonathletic populations, and treatment remain poorly described. Diagnosis and treatment of two extremely rare symptomatic fractures of the superior articular process are discussed.
  
  
  METHODS
  Two male nonathletes presented with sudden lower back and leg pain after usual daily activities. No obvious abnormalities were revealed by radiography, magnetic resonance imaging, or myelography.
  
  
  METHODS
  In both patients, small fractures of the superior articular facet compressing the root shoulder were recognized after further examination, including detailed neurological evaluation of symptoms and targeted thin-slice computed tomography. After failure of conservative treatment, surgical debridement and removal of nonunion fracture were accomplished.
  
  
  CONCLUSIONS
  Symptoms were resolved surgically without further complications or rehabilitation. Fractures of the superior articular facet causing intolerable lower back and sciatic leg pain are rare. We present the first reported cases of these fractures.
authors.affiliation: Department of Neurosurgery, Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Robert Tomohiko
authors.initials: RT
authors.lastname: Numoto
authors.forename: Miyuki
authors.initials: M
authors.lastname: Takeda
authors.forename: Satoshi
authors.initials: S
authors.lastname: Tani
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Abe
mesh_terms: D000328:Adult; D006801:Humans; D008159:Lumbar Vertebrae / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D012447:Sacrum / Q000293:injuries*; D016103:Spinal Fractures / Q000175:diagnosis / Q000601:surgery