Atypical Bilateral Pedicle Fracture in Long-Term Bisphosphonate Therapy

Abstract

A case report with review of the literature. 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. 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. 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. A complete workup showed an isolated bilateral recent fracture of the L5 pedicles without evident etiology. Consolidation was achieved after 3 months of bracing. 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.