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Journal ID : TMJ-07-04-2023-11526
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Title : Polyostotic Fibrous Dysplasia Affected Craniofacial with Thoracic and Lumbar Spine in Adolescents Treated with A Long Segment Spinal Fusion: A Rare Case

Abstract :

Fibrous dysplasia (FD) is a benign tumor-like bone condition. It affects the predilection of long and craniofacial bones, and the prevalence of spine involvement is very low. Most patients with fibrous dysplasia are asymptomatic. However, fibrous dysplasia may be painful or cause swelling. Invasion of medullar bone with fibrous tissue leads to a fragile structure of bone with a risk of fracture and multiple complications [1]. We report a case of polyostotic fibrous dysplasia of craniofacial with spinal involvement affecting the thoracic and lumbar spine simultaneously with severe back pain that came to the emergency department. A Male 13 years old presented with severe back pain that started intermittently four weeks before he came to an orthopedic surgeon. His symptoms were both diurnal and nocturnal, worsening with fatigue and everyday activity. His parent's patient started showing enlargement of the maxilla and mandible at seven years old, and he started to show a kyphotic spine deformity at 8. On physical examination, tenderness of the thoracal and lumbar spine was noted. In the thoracolumbar MRI, there were multiple lesions on the thoracal and lumbal vertebra. The patient was treated with posterior laminectomy and long posterior stabilization and fusion. Satisfactory results were achieved, and there were no complications. The extreme rarity of the disease and its presentation imposes rigorous investigations to rule out malignancies. Surgical treatment was indicated for severe back pain with posterior stabilization and decompression. The surgical treatment gave a good functional outcome and improved the visual analog score.

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