title: Acute L5 pedicle fracture and contralateral spondylolysis in a 12-year-old boy: a case report.
abstract: Acute unilateral L5 pedicle fracture associated with a pre-existing contralateral spondylolysis is a rare lesion. We report a case in a non-competitive 12-year-old boy. We present the clinical, radiological and specific management of this rare condition. The clinical and radiological draft of this patient was reviewed. The follow-up was 30 months after fracture healing. Some cases reported in the literature were analyzed and our clinical findings and therapeutic strategy was compared and discussed. Non-operative treatment was done including full-time bracing in a modified Boston brace incorporating one thigh for 3 months. Plain radiographs and computed tomographic (CT)-scan performed at 3 and 6 months showed progressive healing of the pedicle fracture and no modification of the contralateral isthmic spondylolytic lesion. At final follow-up, the patient was asymptomatic and resumed all his activities. In skeletally immature patients, we think that conservative treatment should be considered as a treatment option for this unusual injury.
authors.affiliation: Department of Paediatric Orthopaedics, Armand Trousseau Hospital, Université Pierre et Marie Curie-Paris VI, 26, avenue du Docteur Arnold Netter, 75571, Paris Cedex 12, France. ravialle@noos.fr
authors.forename: Raphaël
authors.initials: R
authors.lastname: Vialle
authors.forename: Pierre
authors.initials: P
authors.lastname: Mary
authors.forename: Antonio
authors.initials: A
authors.lastname: de Carvalho
authors.forename: Hubert
authors.initials: H
authors.lastname: Ducou le Pointe
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Damsin
authors.forename: Georges
authors.initials: G
authors.lastname: Filipe
mesh_terms: D000058:Accidental Falls; D001915:Braces; D002648:Child; D015775:Fractures, Stress / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D017116:Low Back Pain / Q000209:etiology; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries* / Q000473:pathology; D008297:Male; D016103:Spinal Fractures / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology*; D013169:Spondylolysis / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome