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Simple bone cyst with pathologic lumbar pedicle fracture: a case report
1Department of Orthopedic Surgery, Kang-Nam St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Seoul, Korea. kyh@cmc.cuk.ac.kr
Spine
|April 3, 2003
Summary
A rare simple bone cyst in the lumbar spine pedicle caused severe pain due to a pathologic fracture. Surgical resection led to a favorable outcome, highlighting this unusual spinal cyst presentation.
Area of Science:
- Spine surgery
- Orthopedic pathology
- Radiology
Background:
- Simple bone cysts (SBCs) are rare in the spine, with only nine reported cases.
- Typically, spinal SBCs present with mild pain or are found incidentally.
- This case highlights an SBC in an unusual spinal location with severe presenting symptoms.
Observation:
- A 53-year-old woman presented with sudden, severe back pain radiating to the leg.
- Imaging revealed a cystic lesion in the pedicle of the first lumbar vertebra.
- The lesion was surgically resected for diagnosis and treatment.
Findings:
- Microscopic examination confirmed a simple bone cyst with a fibrous membrane and reactive bone formation.
- No hemorrhage was evident within the cyst.
- Surgical resection resulted in a favorable outcome for the patient.
Implications:
- Simple bone cysts can occur in any spinal region, including the pedicle.
- Pathologic fracture of the pedicle can cause severe pain.
- Nerve compression and chemical irritation from cyst fluid may explain severe symptoms.