title: Atypical bilateral pedicle fracture in long-term bisphosphonate therapy.
abstract: METHODS
  A case report with review of the literature.
  
  
  OBJECTIVE
  To present a first case of an atraumatic bilateral pedicle fracture of L5 in a patient with long-term risedronate therapy and without any previous history of surgery or fracture.
  
  
  BACKGROUND
  A few cases of bilateral osteoporotic pedicle fractures have been reported. All were associated with previous or concomitant corporeal compression fractures. Atypical femoral fractures were recently described with long-term bisphosphonate treatment. To our knowledge, there are no previous reports of isolated bilateral pedicle fracture associated with prolonged bisphosphonate therapy.
  
  
  METHODS
  A 66-year-old woman treated with risedronate for 10 years and without any history of trauma presented with exacerbation of low back pain. No fracture was noted in her past medical history.
  
  
  RESULTS
  A complete workup showed an isolated bilateral recent fracture of the L5 pedicles without evident etiology. Consolidation was achieved after 3 months of bracing.
  
  
  CONCLUSIONS
  We reported the first case of isolated bilateral pedicle fracture in a patient treated with risedronate for 10 years. This may be another atypical fracture in long-term bisphosphonate treatment.
authors.affiliation: Groupe Hospitalier, Saint Joseph, Paris, France. ramirachkidi@hotmail.com
authors.forename: Rami
authors.initials: R
authors.lastname: El Rachkidi
authors.forename: Marie-Laure
authors.initials: ML
authors.lastname: Sari-Leret
authors.forename: Stephane
authors.initials: S
authors.lastname: Wolff
mesh_terms: D000368:Aged; D050071:Bone Density Conservation Agents / Q000009:adverse effects*; D012968:Etidronic Acid / Q000009:adverse effects / Q000031:analogs & derivatives*; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000139:chemically induced; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000187:drug effects / Q000293:injuries; D011859:Radiography; D012196:Review Literature as Topic; D000068296:Risedronic Acid; D016103:Spinal Fractures / Q000139:chemically induced*; D013997:Time Factors
chemical_list: D050071:Bone Density Conservation Agents; D000068296:Risedronic Acid; D012968:Etidronic Acid