骨粗鬆症性脊椎椎体骨折後，椎弓根骨折による遅発性神経根症を生じた1例

Delayed-onset Lumbar Radiculopathy Secondary to a Pedicle Fracture after an Osteoporotic Vertebral Fracture. Case Report

　近年，石元らは骨粗鬆症性脊椎椎体骨折後に生じた遅発性神経根症の4例を報告し，①椎弓根下での後壁の膨隆，②上関節突起の変性肥厚，③膨隆椎間板による3つの病態を提唱した．今回われわれは，骨粗鬆症性脊椎椎体骨折に続発する椎弓根骨折により遅発性神経根症を呈した症例を経験した．神経根ブロックなどの保存的治療には抵抗性であり，後方除圧固定術により症状の改善がみられた．骨粗鬆症性脊椎椎体骨折後に生じる遅発性神経根症の病態として椎弓根骨折を疑う必要性を提唱する．

　Ishimoto et al. recently reported four cases of delayed-onset lumbar radiculopathy secondary to an osteoporotic vertebral fracture and suggested three possible mechanisms for the cause of the radiculopathy pathologies：bulging of the sub-pedicular posterior wall of the vertebral body, degenerative hypertrophy of the superior articular process, and bulging of the intervertebral disc.　Here we report a case of delayed-onset lumbar radiculopathy that was caused by a pedicle fracture.　Surgical treatment was followed by resolution of the patient's refractory leg pain.　We propose that pedicle fracture should be added to the three previously suggested possible mechanisms of delayed-onset lumbar radiculopathy that develops secondary to an osteoporotic vertebral fracture.