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脊柱结核病理性骨折伴椎体内裂隙征:1 例病例报告并文献复习。

Intravertebral cleft in pathological vertebral fracture resulting from spinal tuberculosis: a case report and literature review.

机构信息

Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, No 555, YouYi East road, Xi'an, 710054, China.

Beijing University of Chinese Medicine, 11 North Third Ring Road East, Chaoyang District, Beijing, 100029, China.

出版信息

BMC Musculoskelet Disord. 2020 Sep 18;21(1):619. doi: 10.1186/s12891-020-03642-2.

Abstract

BACKGROUND

Among common findings in osteoporotic vertebral compression fractures (OVCFs), the intravertebral cleft (IVC) is usually considered a benign lesion. The current study was aimed to present a rare case of vertebral fracture caused by IVC-related spinal tuberculosis.

CASE PRESENTATION

A 73-year-old female complained of back pain and weakness in lower limbs for 2 weeks. 3 months ago, after a minor trauma, she got back pain without weakness in lower limbs. Initially, she was diagnosed with a L1 compression fracture and accepted conservative treatment. After an asymptomatic period, she complained progressive pain at the fracture position with weakness of both lower limbs and was referred to our hospital with suspicion of Kümmell's disease. The patient underwent posterior debridement and internal fixation for decompression and stabilization of the spine. Pathological examinations revealed the patient with spinal tuberculosis.

CONCLUSIONS

Although IVC is common in patients with OCVFs, there are some cases believed to be found in patients with spinal tuberculosis or infection. Further test, like CT-guided puncture biopsy, may be required before decisive treatment when an IVC is observed.

摘要

背景

在骨质疏松性椎体压缩性骨折(OVCFs)的常见表现中,椎体内裂隙(IVC)通常被认为是良性病变。本研究旨在报告一例由 IVC 相关脊柱结核引起的罕见椎体骨折病例。

病例介绍

一名 73 岁女性因背痛和下肢无力 2 周就诊。3 个月前,在轻微外伤后,她出现背痛但下肢无力。最初,她被诊断为 L1 压缩性骨折并接受保守治疗。无症状期后,她诉骨折部位进行性疼痛,下肢无力,并因怀疑 Kümmell 病转至我院。患者接受了后路清创和脊柱减压内固定术。病理检查显示患者患有脊柱结核。

结论

尽管 IVC 在 OVCFs 患者中很常见,但也有一些病例被认为发生在脊柱结核或感染患者中。当观察到 IVC 时,在进行决定性治疗之前,可能需要进行 CT 引导下穿刺活检等进一步检查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8321/7501658/00c2a88890e3/12891_2020_3642_Fig1_HTML.jpg

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