Journal de la colonne vertébrale

Monostotic Fibrous Dysplasia of the Lumbar Spine with Pathologic Fracture: A Case Report with Treatment and Follow-up

Abstract

Habibollahzadeh P, Sadat M, Mehrpour SR, Hassanmirzaei B and Mozafari M

Objective: To discuss our experience beside others in order to get a better view about these cases and their management.

Summary of background data: Fibrous dysplasia (FD) is a developmental abnormality of the bone and it represents about 7% of the benign bone tumors; hence vertebral involvement is reported in only 2.5% of all cases. An agreed method of treatment has not been established yet.

Methods: A 33 year old woman with a history of non specific chronic low back pain for more than 3 years, presented with sudden onset of an acute and severe low back pain with normal examination except for a local tenderness on lumbar vertebrae. Encountering a patient presenting red flags, spine radiography, bone scan, spinal CT scan and MRI was done and the patient underwent CT-guided biopsy afterward. When the diagnosis of fibrous dysplasia was done, she was treated with curettage and fixation with cage, screw and allograft insertion.

Results: The patient was followed for one year investigating spine stability, neurological deficit or any other symptoms which represent a one year good follow up outcome.

Conclusion: Based on our experience, here we recommend curettage, cage fixation and allograft insertion in cases of monostotic fibrous dysplasia of the spine when pain, fracture or instability exists.