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Case Reports in Orthopedics
Volume 2013, Article ID 497458, 4 pages
http://dx.doi.org/10.1155/2013/497458
Case Report

Spontaneous Symptomatic Pseudoarthrosis at the L2-L3 Intervertebral Space with Diffuse Idiopathic Skeletal Hyperostosis: A Case Report

Department of Orthopaedic Surgery, Toho University School of Medicine, 6-11-1 Omori-Nishi Ota-ku, Tokyo 143-8541, Japan

Received 26 July 2013; Accepted 1 October 2013

Academic Editors: W. I. Faisham, M. Gotoh, W. Kolb, and W. B. Rodgers

Copyright © 2013 Keiji Hasegawa et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Pseudoarthrosis at the intervertebral space in patients with ankylosing spondylitis has occasionally been reported, but symptomatic pseudoarthrosis at the intervertebral disc level is rare in patients with diffuse idiopathic skeletal hyperostosis (DISH). Here, we report a case of symptomatic pseudoarthrosis at the L2-L3 intervertebral space that was diagnosed based on clinical history. We first performed L1–L5 fixation, but back-out of the pedicle screw occurred in the early postoperative phase and may have been caused by a short fixation range and concomitant Parkinson’s disease. However, the prognosis of the case was favorable after a second surgery. This case indicates that a fixation range of at least 3 above and 3 below is necessary for bone fracture of a thoracolumbar vertebra and pseudoarthrosis in patients with DISH.