OBJECTIVE AND IMPORTANCE: 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. CLINICAL PRESENTATION: 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. INTERVENTION: 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. CONCLUSION: 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.
OBJECTIVE AND IMPORTANCE: 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. CLINICAL PRESENTATION: 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. INTERVENTION: 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. CONCLUSION: 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: Dalavaye S Kumar; Anastasia Fotiadou; Radhesh Lalam; Laurence M Ginder; Stephen M Eisenstein; Bernard J Tins; Prudencia N M Tyrrell; John M Delieu; Iain W McCall; Dai A Rees; Victor N Cassar-Pullicino Journal: Skeletal Radiol Date: 2012-05-27 Impact factor: 2.199