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Vertebral aneurysmal bone cyst. A case report and review.
M R Brinker1, T S Whitecloud, P T James
1Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, Louisiana.
Orthopaedic Review
|January 1, 1991
Summary
Aneurysmal bone cysts in the lumbar spine can cause severe back pain and leg weakness. Surgical intervention for this rare condition, combined with herniated disc treatment, led to full symptom resolution in a teenage patient.
Area of Science:
- Orthopedics
- Neurosurgery
- Pediatric Spine Surgery
Background:
- Aneurysmal bone cysts (ABCs) are rare, benign, expansile bone tumors. Vertebral ABCs can cause significant spinal cord compression and neurological deficits.
- Herniated nucleus pulposus (HNP) at the L4-L5 level is a common cause of lower back pain and radiculopathy.
Observation:
- A 16-year-old male presented with progressive lower back pain and bilateral lower extremity weakness.
- Radiographic imaging revealed an aneurysmal bone cyst of the fourth lumbar vertebra causing neural canal compromise and an associated L4-L5 herniated nucleus pulposus.
Findings:
- Surgical treatment involved tumor excision, L4-L5 discectomy, lumbar decompression, and combined posterolateral and anterior lumbar fusion.
- The patient experienced complete resolution of lower back pain and lower extremity weakness postoperatively.
Implications:
- This case highlights the successful surgical management of a complex spinal condition involving both a vertebral aneurysmal bone cyst and a herniated disc in an adolescent.
- Aggressive surgical decompression and stabilization can lead to excellent functional recovery in young patients with combined spinal pathologies.