IDIOPATHIC AVASCULAR NECROSIS OF A VERTEBRAL BODY - CASE-REPORT AND LITERATURE-REVIEW

Study Design. Case report and literature review. Objectives. To review the English literature pertaining to idiopathic avascular necrosis of a vertebral body. As an illustrative example, the case of a 60-year-o ld woman with idiopathic avascular necrosis of L4 is presented. Summar y of Background Data. Avascular necrosis of a vertebral body is an unc ommon entity. Avascular necrosis has been described in the context of other underlying lesions, such as with malignancy, infection, radiatio n therapy, and systemic steroid treatment. The intravertebral vacuum c left phenomenon seen on plain films has been strongly associated with vertebral body avascular necrosis.Methods. Literature and chart review was carried out. Vertebral body avascular necrosis was initially iden tified with imaging studies and confirmed with biopsy. A comprehensive preoperative evaluation did not identify a specific cause of avascula r necrosis. The patient underwent vertebral body resection with fibula allograft struts. Conclusions. Although vertebral body collapse in an osteoporotic individual is relatively common, a case is reported of v ertebral body collapse and subsequent necrosis without evidence of und erlying disease at 48-month follow-up. The current findings support th e diagnosis of idiopathic avascular necrosis of L4.