Management of a Lumbar Burst Fracture Occurring After a Sneeze in a Patient Affected by Systemic Mastocytosis: A Case Report

August 28, 2021

doi: 10.2106/JBJS.CC.20.00259.

Affiliations

Item in Clipboard

Federico De Iure et al.

JBJS Case Connect.

2021.

doi: 10.2106/JBJS.CC.20.00259.

Affiliations

¹ Department of Spine Surgery – Maggiore Hospital, Bologna, Italy.
² Department of Orthopedics and Traumatology – Maggiore Hospital, Bologna, Italy.
³ Department of Orthopedics – IRCCS Orthopedic Institute Galeazzi, Milan, Italy.
⁴ Department of Orthopedics and Traumatology – Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Item in Clipboard

Abstract

Case:

We present a 36-year-old man with L1 burst fracture after a sneeze. He was in follow-up for indolent systemic mastocytosis (ISM), and osteoporosis was treated with bisphosphonate. Owing to neurologic impairment, posterior decompressive laminectomy and thoraco-lumbar fusion with cemented screws were performed.

Conclusion:

Vertebral fractures in young patients affected by ISM required a multidisciplinary approach and a careful preoperative planning to achieve acceptable results. These fractures are so rare that even an experienced spine surgeon may not come across them during his whole career. Nevertheless, diagnostic tool improvement makes its diagnosis more frequent, that is why every spine surgeon should know this disease.

Conflict of interest statement

Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSCC/B653).

References

1. Valent P. Mastocytosis: a paradigmatic example of a rare disease with complex biology and pathology. Am J Cancer Res. 2013;3(2):159-72.
1. Cainelli T, Marchesi L, Pasquali F, Rozzoni M. Monozygotic twins discordant for cutaneous mastocytosis. Arch Dermatol. 1983;119(12):1021-2.
1. Broesby-Olsen S, Kristensen TK, Møller MB, Bindslev-Jensen C, Vestergaard H. Adult-onset systemic mastocytosis in monozygotic twins with KIT D816V and JAK2 V617F mutations. J Allergy Clin Immunol. 2012;130(3):806-8.
1. Chang A, Tung RC, Schlesinger T, Bergfeld WF, Dijkstra J, Kahn TA. Familial cutaneous mastocytosis. Pediatr Dermatol. 2001;18(4):271-6.
1. Valent P, Akin C, Escribano L, Födinger M, Hartmann K, Brockow K, Castells M, Sperr WR, Kluin-Nelemans HC, Hamdy NA, Lortholary O, Robyn J, van Doormaal J, Sotlar K, Hauswirth AW, Arock M, Hermine O, Hellmann A, Triggiani M, Niedoszytko M, Schwartz LB, Orfao A, Horny HP, Metcalfe DD. Standards and standardization in mastocytosis: consensus statements on diagnostics, treatment recommendations and response criteria. Eur J Clin Invest. 2007;37(6):435-53.