A case study of unusual benign osseous lesion of the L5 lamina.
BACKGROUND
The differential diagnosis of benign-appearing posterior element lesions is complex.


OBJECTIVE
To explore the etiology of an unusual benign lesion found on the lamina of L5 described in a case report.


METHODS
Case report. The patient's medical, surgical and imaging histories as well as medical literature were reviewed.


RESULTS
A 35-year old male complained of low back pain radiating to both legs for 5 months. Abdominal CT scan 1 year prior as well as post symptom-onset CT and MRI showed a well-corticated lesion lateral to the spinous process of L5. After failed rehabilitation and injection, operation revealed normal cortical bone. Pain was not markedly relieved post-operatively.


CONCLUSIONS
The pre-surgical differential diagnosis of this lesion included osteosarcoma and osteoid osteoma, however benign pathological results suggest the possibility of atypical spina bifida occulta, Baastrup changes, atypical sacralization of L5, or a resolved fracture with heterotopic ossification.
College of Osteopathic Medicine, University of New England, Biddeford, ME, USA.
Matthew B
MB
Sonagere
Department of Physical Medicine and Rehabilitation, The University of Michigan, Ann Arbor, MI, USA.
Andrew J
AJ
Haig
Department of Orthopedic Surgery, The University of Michigan, Ann Arbor, MI, USA.
Rakish
R
Patel
Department of Pathology, The University of Michigan, Ann Arbor, MI, USA.
David R
DR
Lucas
Department of Radiology, The University of Michigan, Ann Arbor, MI, USA.
Diana
D
Gomez-Hassan
D000328:Adult; D006801:Humans; D017116:Low Back Pain / Q000000981:diagnostic imaging* / Q000473:pathology; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D011859:Radiography
Lumbar spine; back pain; congenital anomaly; facet joint; sacralization of L5; spinous process