Thoracolumbar vertebral coronal split fracture with disruption of the anterior bony bridge resulting in low back pain: Case report

Yongfen Zeng; Shujiang Wang; Xueqing Lv; Zhuqiang Cheng

doi:10.1016/j.ijscr.2025.111535

Thoracolumbar vertebral coronal split fracture with disruption of the anterior bony bridge resulting in low back pain: Case report

Int J Surg Case Rep. 2025 Jun 19:133:111535. doi: 10.1016/j.ijscr.2025.111535. Online ahead of print.

Authors

Yongfen Zeng¹, Shujiang Wang¹, Xueqing Lv¹, Zhuqiang Cheng²

Affiliations

¹ Department of Pain, Nanjing Jinling Hospital, Nanjing 210003, China.
² Department of Pain, Nanjing Jinling Hospital, Nanjing 210003, China; Department of Anesthesiology, The Fourth Affiliated Hospital of Nanjing Medical University, Nanjing 210031, China. Electronic address: zqcheng123@126.com.

PMID: 40570482
DOI: 10.1016/j.ijscr.2025.111535

Abstract

Introduction and importance: This paper documents a case of low back pain(LBP) in an elderly female patient caused by coronal split-compression fractures of the thoracolumbar spine with anterior bony bridge disruption. The report comprehensively elaborates on the diagnostic approaches, treatment strategies and postoperative rehabilitation trajectory to emphasize the importance of meticulous clinical physical examination and appropriate imaging examination for physicians.

Case presentation: A 65-year-old female was admitted for severe LBP. She had a five-year history of LBP exacerbated by bending and lifting. After a series of diagnostic procedures, the patient was ultimately diagnosed with vertebral fracture accompanied by anterior vertebral bridge fracture, and also with osteoporosis. She underwent posterior open reduction and pedicle screw fixation at T12-L2. Her pain vanished and motor function improved after surgery.

Clinical discussion: It is imperative to ascertain the existence of spinal fractures, osteoporosis and additional conditions for patients with LBP. Despite the significant role of Magnetic Resonance Imaging (MRI) plain scans in diagnosing spinal conditions, spinal X-rays, computed tomography (CT) scans and MRI fat-suppressed images offer more precise diagnostic information for LBP, thereby enabling the selection of the most suitable treatment regimen.

Conclusion: Clinicians should conduct bone density tests, spinal X-rays, CT scans and MRI sequences to accurately diagnose and treat LBP patients.

Keywords: Anterior bony bridge rupture; Coronal plane; Osteoporosis; Pain; Split; Vertebral compression fracture.

Publication types

Case Reports