Thoracolumbar Spine Anatomy and Pathology - Midlumbar Vertebra

Pathological fracture of a midlumbar vertebra that had been weakened by a hypernephroma metastasis. Both the upper and the lower endplates have yielded in an almost symmetrical fashion and triangular bone fragments are tilted so as to create the appearance of a 'fish vertebra'. The overall height of this vertebral segment is slightly decreased but no there is no major sagittal kyphotic angulation. The adjacent discs have expanded in a compensatory fashion and they seem to have exploded into the collapsed vertebra. Posteriorly in the vertebra, infiltration of cancerous growth in the area of the Batson venous plexus and through the vascular outlet foramina causes the periosteum and the dura to bulge posteriorly into the vertebral canal. Note that the disc margins are almost straight anteriorly and posteriorly. The vertebra below is normal and has natural cancellous bone texture and red bone marrow. In its posterior wall a normal basivertebral vein outlet is seen.

©2000 Wolfgang Rauschning, M.D., Ph.D.
Professor of Clinical Anatomy
Academic University Hospital
Department of Orthopaedic Surgery
Uppsala, Sweden
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