Funayama Toru, Gasbarrini Alessandro, Ghermandi Riccardo, Girolami Marco, Boriani Stefano
Department of Oncologic and Degenerative Spine Surgery, Rizzoli Orthopedic Institute, Via G. C. Pupilli 1, 40136, Bologna, Italy.
Eur Spine J. 2017 May;26(Suppl 1):58-62. doi: 10.1007/s00586-016-4736-5. Epub 2016 Aug 23.
We describe a rare case of solitary bone cyst involving the vertebral body of L4.
To the best of the authors' knowledge, only 15 cases of solitary bone cysts involving the spine have been reported previously. All the reported cases were treated surgically, including resection and curettage with or without bone grafting. In the current case, treatment was with steroid injection alone.
A cystic lesion involving the vertebral body of L4 was identified in a 16-year-old girl with persistent low back pain of 2 years' duration. According to the radiological characteristics of the lesion, a diagnosis of solitary bone cyst was suspected. The patient underwent surgical intervention with percutaneous steroid injection alone since there was no evidence of thinned cortex or pathological fracture. The patient was discharged 2 days after this intervention with resolution of the low back pain.
At the final follow-up 7 months after treatment, the patient was asymptomatic and the beginning of bony healing was evident.
Herein, we reported an extremely rare case of solitary bone cyst involving the body of the fourth lumbar vertebra. Local steroid injection should be considered as a minimally invasive intervention for a solitary bone cyst involving the spinal column with no evidence of thinned cortex or pathological fracture.
我们描述了一例罕见的累及L4椎体的孤立性骨囊肿病例。
据作者所知，此前仅报道过15例累及脊柱的孤立性骨囊肿病例。所有报道的病例均接受了手术治疗，包括切除和刮除术，有或没有植骨。在本病例中，仅采用类固醇注射治疗。
在一名患有持续2年下腰痛的16岁女孩中发现了一个累及L4椎体的囊性病变。根据病变的影像学特征，怀疑为孤立性骨囊肿。由于没有皮质变薄或病理性骨折的证据，患者仅接受了经皮类固醇注射的手术干预。干预后2天患者出院，下腰痛症状消失。
在治疗后7个月的最后随访中，患者无症状，并且明显开始出现骨愈合。
在此，我们报告了一例极其罕见的累及第四腰椎体的孤立性骨囊肿病例。对于没有皮质变薄或病理性骨折证据的累及脊柱的孤立性骨囊肿，局部类固醇注射应被视为一种微创干预措施。
