Traumatic lumbar pedicle fracture associated with pre-existing bilateral spondylolysis and anterolisthesis in a professional soccer player

摘要

A traumatic pedicle fracture in association with pre-existing bilateral spondylolysis and anterolisthesis has never been described. A 27-year-old male professional football player presented with acute gluteal pain caused by a traumatic fracture of the left pedicle L5 missed on plain radiographs, but seen on CT-scan and confirmed on bone scintigraphy. Instability caused by this fracture in association with pre-existing bilateral spondylolysis and grade I-anterolisthesis required immobilization of the lumbar spine. Since no neurological deficit was observed, it was decided not to operate but to treat the patient with analgesics and with a lumbar orthosis which would provide unilateral hip fixation in extension during walking. We report here on the difficulties of diagnosis and on the successful treatment by means of immobilization in a lumbar orthosis. A rehabilitation program with specific sports-related exercises was devised.