Pathological Fracture of Lumbar Vertebra in Children With Acute Neurological Deficit: Case Report

Abstract

This study reports on a case of lymphoma in a 13-year-old patient who came to a consultation with lumbar pain. The patient had suffered low-intensity trauma in the lumbar region that resulted in persistent pain of progressive nature. In an emergency evaluation, radiographic examination showed a spinal fracture. The patient was then sent to the specialist outpatient clinic of the same hospital. The initial examinations confirmed the diagnosis of a pathological fracture surrounded by a tissue mass, thus indicating the presence of a tumor. Subsequently, the patient evolved with lower-limb paresthesia and urine retention, without any pathological diagnosis for the lesion. The patient then underwent emergency surgery to achieve stabilization and neurological decompression, and material from the lesion was sent for anatomopathological examination. The result from the anatomopathological examination suggested that the lesion was a small-cell tumor, although leaving some doubt. Immunohistochemistry defined the diagnosis of lymphoma. The patient was then sent for oncological treatment. The aim of this study was to report on a rare case of lymphoma in a child with an initial diagnosis of a pathological fracture in the lumbar spine. It is important to investigate fractures associated with mild trauma in children. Precise diagnosis results in effective attendance with better results for these patients.This patient underwent chemotherapy and achieved a good response, with positive repercussions for his prognosis.

Pathological fractures of the spine in children (review of the literature and clinical and morphological monocenter cohort analysis)

“…При стремительном развитии неврологических расстройств на фоне лимфом и гистиоцитоза из клеток Лангерганса грудных позвонков у детей рекомендуют выполнять экстренную декомпрессию спинного мозга с одновременной откры той биопсией [15]. В то же время получены сходные отдаленные (более 3 лет) ортопедические и онкологические результаты лечения неврологически осложненного гистиоцитоза из клеток Лангерганса как при реконструкции позвоночника 360° (стабилизация, спондилодез передней и задней колонн позвоночника), так и при изолированной задней декомпрессии с транспедикулярной фиксацией, при меньшей травматичности последнего вмешательства [16].…”