Avascular necrosis of the spine in solid posterior fusion segments.
METHODS
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.


BACKGROUND
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.


CONCLUSIONS
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.
Lee
Jung-Hee
JH
Kyung Hee Medical Center, School of Medicine, Kyung Hee University, Seoul, Korea.
Kim
Ki-Tack
KT
Suk
Kyung-Soo
KS
Lee
Sang-Hun
SH
Jeong
Bi-O
BO
D001416:Back Pain / Q000209:etiology; D005260:Female; D006801:Humans; D007738:Kyphosis / Q000209:etiology; D007796:Laminectomy; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D010020:Osteonecrosis / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D012086:Reoperation; D013118:Spinal Cord Diseases / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D016103:Spinal Fractures / Q000601:surgery*; D013123:Spinal Fusion / Q000009:adverse effects*; D013904:Thoracic Vertebrae / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome