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Pathological vertebral crush fracture: plasmacytoma

Case contributed by J. Ray Ballinger
Diagnosis certain

Presentation

History of back pain for 4 weeks. Presents with acute worsening without trauma.

Patient Data

Age: 60 years

A pathological compression fracture of L1 is seen on plain films

CT axial image through L1 and sagittal reconstructions show a heterogenous lytic lesion of the vertebral body and posterior elements.

Case Discussion

The diagnosis of plasmacytoma was suggested by percutaneous needle biopsy and confirmed at surgery when a rib strut graft and plate were placed between T12 and L1.

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