Pathologic Fracture in Cervical Spine with Monostotic Fibrous Dysplasia - Case Report -

Kyung-Jin Song; Gyu-Hyung Kim

doi:10.4055/jkoa.2008.43.2.252

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Song and Kim: Pathologic Fracture in Cervical Spine with Monostotic Fibrous Dysplasia - Case Report -

Case Report

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2008; 43(2): 252-256.

Published online: 30 April 2008

DOI: https://doi.org/10.4055/jkoa.2008.43.2.252

Pathologic Fracture in Cervical Spine with Monostotic Fibrous Dysplasia - Case Report -

Kyung-Jin Song, M.D., Gyu-Hyung Kim, M.D.

Department of Orthopedic Surgery, College of Medicine, Institute for Medical Science, Chonbuk National University Hospital, Jeonju, Korea.

Address reprint requests to Gyu-Hyung Kim, M.D. Department of Orthopedic Surgery, Chonbuk University Hospital, 634-18, Geumam-dong, Deokjin-gu, Jeonju 561-712, Korea. Tel: +82-63-250-1760, 2300, Fax: +82-63-271-6538, cbnuhosman@naver.com

Abstract

Fibrous dysplasia is a developmental anomaly of bone formation, which is characterized by a replacement of the normal bone and marrow by fibrous tissue as well as small, woven spicules of bone. These lesions may exist in a monostotic or polyostotic form and are generally found in the 4^th decade of age or younger with a slightly higher incidence in girls than boys. We report a case of monostotic fibrous dysplasia that was associated with a pathologic fracture and a kyphotic deformity in the cervical spine.

Keywords: Cervical spine, Monostotic fibrous dysplasia, Pathologic fracture

Figures and Tables

Fig. 1

The plain radiograph shows a ground glass pattern lesion of the body of the 4^th and 5^th cervical vertebra. (A) Preoperative C-spine AP view. (B) Preoperative C-spine Lateral view. (C) Preoperative C-spine Rt. oblique view. (D) Preoperative C-spine Lt. oblique view.

Fig. 2

The computed tomogram shows the loss of the anterior portion of the 4^th and 5^th cervical vertebra as well as local kyphosis of the cervical spine. (A) Preoperative CT sagittal view. (B) Preoperative C4 axial view. (C) Preoperative C5 axial view.

Fig. 3

The preoperative magnetic resonance images shows an expansile and low signal density lesion of the vertebral body, pedicle, lamina and spinal canal involvement of 4^th and 5^th cervical vertebrae. (A) High signal intensity on the T2-weighted sagittal view. (B) High signal intensity on the T2-weighted C4 axial view. (C) High signal intensity on the T2-weighted C5 axial view.

Fig. 4

The histology section shows the vertebrae to be largely replaced by proliferating fibrous connective tissue with focally presenting woven bone trabeculae (chinese letter appearance). (A) H and E stain, ×40. (B) H and E stain, ×100. (C) H and E stain, ×200.

Fig. 5

Postoperative radiographs shows anterior and posterior fusion and posterior stabilization of C3-6 using the Bohlman triple wiring technique. (A) Postoperative C-spine AP view. (B) Postoperative C-spine Lateral view.

Fig. 6

Radiographs of the 29 months follow-up showing complete union of the third to sixth cervical vertebral level. (A) C-spine AP view. (B) C-spine Lateral view. (C) C-spine Flexion view. (D) C-spine Extension view.

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