Abstract
BackgroundMonostotic fibrous dysplasia (MFD) involving the spine is rare, and the treatment options are controversial. Surgery is needed when patients suffer from persistent pain, spinal cord compression/injury, and vertebral collapse/instability. Treatment methods include biopsy/observation, corpectomy with instrumented fusion, posterior fusion, vertebroplasty (VP), curettage and bone graft, and complete removal of the vertebra with a combined anterior and posterior fusion procedure.Case presentationThe patient was a 56-year-old woman with a 2-year history of neck pain. No obvious abnormalities were detected on neurological or physical examination, and laboratory findings were all within normal limits. An imaging examination suggested a C7 vertebral bone tumor. The patient refused to continue conservative observation treatment and requested surgery. Open VP of the C7 vertebral body was carried out, and her postoperative neck pain was completely relieved. The postoperative pathological results supported the diagnosis of fibrous dysplasia, and the patient was ultimately diagnosed with MFD. At the 12-month follow-up visit, the patient reported no clinical symptoms, and no signs of tumor recurrence were detected.ConclusionVP can relieve pain while stabilizing the spine. Thus, the surgical treatment of MFD vertebral lesions by VP is a valuable option.
Highlights
Monostotic fibrous dysplasia (MFD) involving the spine is rare, and the treatment options are controversial
Fibrous dysplasia (FD) can be classified as monostotic fibrous dysplasia (MFD) or polyostotic fibrous dysplasia (PFD)
There are several challenges in the application of VP for MFD: (1) It is difficult to accurately diagnose the disease preoperatively because there is a lack of characteristic imaging manifestations, and the FD diagnosis depends on pathology results; in addition, Computed tomography (CT)-guided percutaneous biopsy for the evaluation of spinal lesions has a reported diagnostic accuracy of approximately 90% [36]
Summary
Fibrous dysplasia (FD) was first reported by Lichtenstein in 1938 [1]. FD can be classified as monostotic fibrous dysplasia (MFD) or polyostotic fibrous dysplasia (PFD). MFD accounts for 70% of the reported cases of FD. MFD involving the cervical vertebrae is quite rare, and the treatment methods are controversial. Case presentation A 56-year-old female patient was admitted to our hospital with a 2-year history of neck pain. Computed tomography (CT) (Fig. 1a, b) demonstrated low density in the seventh cervical vertebra, with high-density hardening visible around the edges. The postoperative pathological results supported the diagnosis of FD (Fig. 5a, b), and the patient was diagnosed with MFD. At the 12-month follow-up visit, the patient reported no clinical symptoms, and no signs of tumor recurrence were detected
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