Avascular necrosis of the spine in solid posterior fusion segments.

STUDY

DESIGN

Case report.

OBJECTIVE

We present a rare case of avascular necrosis of a vertebral body in solid posterior fusion segments without trauma and its possible mechanism.

SUMMARY OF BACKGROUND DATA: The reported case is that of a 56-year old woman with posterior spinal fusion (T10-L2) for a fracture of T12 presenting with progressive kyphosis, back pain and neurologic deficits developing with no history of trauma. Serial radiographs, computed tomography, and magnetic resonance imaging scans confirmed avascular necrosis of the 11th thoracic vertebral body.

METHODS

This is a retrospective review of a case seen at our hospital.

RESULTS

The symptoms were successfully treated by resection of the necrotic vertebral body and correction of the deformity.

CONCLUSION

Despite solid posterior fusion segments, avascular necrosis of a vertebral body developed without trauma. This may be attributed to a wedged vertebra that causes repeated microtrauma and resulting avascular necrosis on the adjacent vertebra. Surgical treatment is required in avascular necrosis of a vertebral body with progressive collapse and neurologic compromise secondary to osteoporotic fracture adjacent to a wedge-shaped vertebra at the thoracolumbar junction.