Yoshihara Hiroyuki, Nojiri Kenya, Yabe Mariko, Takahata Takeshi
NYU Hospital for Joint Diseases, New York, New York, USA.
BMJ Case Rep. 2013 May 31;2013:bcr2013009075. doi: 10.1136/bcr-2013-009075.
In primary amyloidosis (AL), a fibrillar protein (amyloid light chain) is deposited in many organs; however, it is rare to have involvement of the vertebral bodies. Multiple myeloma is a well-known systemic amyloid disease that frequently has vertebral involvement. However, the pathology of vertebral involvement of these two clinical entities differs significantly. We report a patient with L4 vertebral collapse because of primary AL, causing neurological compromise that improved with surgical treatment. Deposition of amyloid and following demineralisation caused the vertebral collapse. Primary AL needs to be taken into consideration as a cause of pathological vertebral fracture.
在原发性淀粉样变性（AL）中，一种纤维状蛋白（淀粉样轻链）沉积于许多器官；然而，椎体受累情况罕见。多发性骨髓瘤是一种众所周知的全身性淀粉样疾病，常累及椎体。然而，这两种临床实体的椎体受累病理情况有显著差异。我们报告一例因原发性AL导致L4椎体塌陷的患者，其出现神经功能损害，经手术治疗后改善。淀粉样物质沉积及随后的脱矿质作用导致了椎体塌陷。原发性AL应被视为病理性椎体骨折的一个病因。
