{"id":"134a4a06-be95-49d3-a3a8-7cb695b9bad2","slug":"symptomatic-congenital-appearing-l2-pediculosis-in-a-young-athlete-successful-management-with-unilateral-trans-lytic-screw-fixation","title":"Symptomatic congenital-appearing L2 pediculosis in a young athlete: Successful management with unilateral trans-lytic screw fixation","authors":["Pauline Carlier","Anthony Fichten"],"abstract":"Background: Nontraumatic pedicle fractures are rare stress-related lesions. The coexistence of unilateral isthmic lysis with contralateral pediculosis is exceptional. Case Description: A 20-year-old male presented with disabling mechanical left-sided low back pain, worsened after a road traffic accident, but neurologically intact. The magnetic resonance imaging revealed a left L2 pedicle lysis with adjacent bone marrow edema. The computed tomography (CT) confirmed a congenital left pediculosis associated with a right L2 isthmic lysis. =Under O-arm imaging, a left L2 pedicle compression screw was placed (i.e., percutaneous, transmuscular insertion). The post-operative course was uneventful, and he achieved immediate pain relief. At 4 months later, the patient was asymptomatic, and radiographs showed fusion. Conclusion: A 20-year-old male with left L2 pedicle lysis, adjacent bone marrow edema, and CT confirmed a congenital left pediculosis with right L2 isthmic lysis was successfully treated with a minimally invasive (O-arm directed left L2 pedicle compression screw placement), resulting in full symptomatic relief and adequate radiographic stabilization.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/134a4a06-be95-49d3-a3a8-7cb695b9bad2/featured/hero-1781558233598.png","publishDate":"2025-10-31T00:00:00.000Z","doi":"10.25259/SNI_925_2025","categories":["Spine","Case Report"],"fullTextUrl":"https://surgicalneurologyint.com/api/articles/134a4a06-be95-49d3-a3a8-7cb695b9bad2/pdf"}