Intravertebral cleft in pathological vertebral fracture resulting from spinal tuberculosis: a case report and literature review

BMC Musculoskelet Disord. 2020 Sep 18;21(1):619. doi: 10.1186/s12891-020-03642-2.

Abstract

Background: Among common findings in osteoporotic vertebral compression fractures (OVCFs), the intravertebral cleft (IVC) is usually considered a benign lesion. The current study was aimed to present a rare case of vertebral fracture caused by IVC-related spinal tuberculosis.

Case presentation: A 73-year-old female complained of back pain and weakness in lower limbs for 2 weeks. 3 months ago, after a minor trauma, she got back pain without weakness in lower limbs. Initially, she was diagnosed with a L1 compression fracture and accepted conservative treatment. After an asymptomatic period, she complained progressive pain at the fracture position with weakness of both lower limbs and was referred to our hospital with suspicion of Kümmell's disease. The patient underwent posterior debridement and internal fixation for decompression and stabilization of the spine. Pathological examinations revealed the patient with spinal tuberculosis.

Conclusions: Although IVC is common in patients with OCVFs, there are some cases believed to be found in patients with spinal tuberculosis or infection. Further test, like CT-guided puncture biopsy, may be required before decisive treatment when an IVC is observed.

Keywords: Case report; Intravertebral cleft; Spinal tuberculosis; Vertebral fracture.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Female
  • Fractures, Compression*
  • Fractures, Spontaneous*
  • Humans
  • Osteoporotic Fractures*
  • Spinal Fractures* / complications
  • Spinal Fractures* / diagnostic imaging
  • Spine
  • Treatment Outcome
  • Tuberculosis, Spinal* / complications
  • Tuberculosis, Spinal* / diagnostic imaging
  • Tuberculosis, Spinal* / surgery