J Korean Orthop Assoc.  2008 Apr;43(2):252-256. 10.4055/jkoa.2008.43.2.252.

Pathologic Fracture in Cervical Spine with Monostotic Fibrous Dysplasia: Case Report

Affiliations
  • 1Department of Orthopedic Surgery, College of Medicine, Institute for Medical Science, Chonbuk National University Hospital, Jeonju, Korea. cbnuhosman@naver.com

Abstract

Fibrous dysplasia is a developmental anomaly of bone formation, which is characterized by a replacement of the normal bone and marrow by fibrous tissue as well as small, woven spicules of bone. These lesions may exist in a monostotic or polyostotic form and are generally found in the 4th decade of age or younger with a slightly higher incidence in girls than boys. We report a case of monostotic fibrous dysplasia that was associated with a pathologic fracture and a kyphotic deformity in the cervical spine.

Keyword

Cervical spine; Monostotic fibrous dysplasia; Pathologic fracture

MeSH Terms

Bone Marrow
Congenital Abnormalities
Fibrous Dysplasia, Monostotic
Fractures, Spontaneous
Incidence
Osteogenesis
Spine

Figure

  • Fig. 1 The plain radiograph shows a ground glass pattern lesion of the body of the 4th and 5th cervical vertebra. (A) Preoperative C-spine AP view. (B) Preoperative C-spine Lateral view. (C) Preoperative C-spine Rt. oblique view. (D) Preoperative C-spine Lt. oblique view.

  • Fig. 2 The computed tomogram shows the loss of the anterior portion of the 4th and 5th cervical vertebra as well as local kyphosis of the cervical spine. (A) Preoperative CT sagittal view. (B) Preoperative C4 axial view. (C) Preoperative C5 axial view.

  • Fig. 3 The preoperative magnetic resonance images shows an expansile and low signal density lesion of the vertebral body, pedicle, lamina and spinal canal involvement of 4th and 5th cervical vertebrae. (A) High signal intensity on the T2-weighted sagittal view. (B) High signal intensity on the T2-weighted C4 axial view. (C) High signal intensity on the T2-weighted C5 axial view.

  • Fig. 4 The histology section shows the vertebrae to be largely replaced by proliferating fibrous connective tissue with focally presenting woven bone trabeculae (chinese letter appearance). (A) H and E stain, ×40. (B) H and E stain, ×100. (C) H and E stain, ×200.

  • Fig. 5 Postoperative radiographs shows anterior and posterior fusion and posterior stabilization of C3-6 using the Bohlman triple wiring technique. (A) Postoperative C-spine AP view. (B) Postoperative C-spine Lateral view.

  • Fig. 6 Radiographs of the 29 months follow-up showing complete union of the third to sixth cervical vertebral level. (A) C-spine AP view. (B) C-spine Lateral view. (C) C-spine Flexion view. (D) C-spine Extension view.


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