title: [Research progress of stress fracture of lumbar pedicle].
abstract: OBJECTIVE
  To review the research progress of stress fracture of the lumbar pedicle.
  
  
  METHODS
  The literature about the stress fracture of the lumbar pedicle was reviewed extensively and summarized.
  
  
  RESULTS
  There are two types of stress fracture: fatigue and structure insufficient. Stress fracture of lumbar pedicle occurred mainly in the crowd with repetitive and large activities of spine, contralateral spondylolysis, or previous surgery of lumbar vertebra. The main stresses causing stress fracture of the lumbar pedicle are shear stress and twisting stress, followed by sudden hyperflexion or hyperextension of the spine. Stress fracture of lumbar pedicle was easily missed by conventional X-ray examination, usually XCT, MRI, or bone scan was needed to confirm the diagnosis. It is divided into 4 types or 4 periods according to MRI findings: stress reaction, incomplete fracture, complete fracture, and pseudarthrosis. For patients with incomplete, complete, and juvenile stress fractures of the lumbar pedicle without nerve root irritation, the majority of claims preferred conservative treatment and the healing rate of fracture was high; for patients with bilateral pseudarthrosis and with nerve root irritation as well as patients who failed to the conservative treatment, surgical management was advocated and the operation result is good.
  
  
  CONCLUSIONS
  Stress fracture of the lumbar pedicle as one of the causes of low back pain is extremely rare, and is easily missed clinically. Surgery or conservative management should be selected based on type of fracture and specific condition of the patient, the treatment results are satisfactory.
authors.affiliation: Department of Orthopaedics, the 9th People's Hospital of Wuxi, Wuxi Jiangsu, 214062, P.R.China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Liu
authors.forename: Qudong
authors.initials: Q
authors.lastname: Yin
authors.forename: Sanjun
authors.initials: S
authors.lastname: Gu
authors.forename: Zhenzhong
authors.initials: Z
authors.lastname: Sun
authors.forename: Yongjun
authors.initials: Y
authors.lastname: Rui
authors.forename: Kuishui
authors.initials: K
authors.lastname: Shou
mesh_terms: D001863:Bone Screws; D005593:Fracture Fixation, Internal / Q000379:methods; D015775:Fractures, Stress / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D006801:Humans; D017116:Low Back Pain / Q000209:etiology / Q000628:therapy; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D016103:Spinal Fractures / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D013123:Spinal Fusion / Q000009:adverse effects; D014057:Tomography, X-Ray Computed / Q000379:methods