A Case of Non-traumatic Vertebral Compression Fracture in a Young Dancer

Dr Colm Shahmohammadi (SHO Emergency Medicine), Dr Housameddin Ghazzawi (Emergency Medicine Consultant), Dr Alister McIlwee (Emergency Medicine Consultant, Clinical Director Ulster Hospital SEHSCT)

Non-traumatic vertebral compression fractures are relatively common in elderly osteoporotic patients and with those with bony disease including bony metastases, however are rare in young healthy patients. This report presents a case of non-traumatic vertebral compression fracture in a young dancer.

The above named are the sole authors of this case. Consent was obtained from the patient to produce this case report. 

A previously fit and healthy 18 year old girl presented to ED with a 2 year history of back pain.  She had attended her GP on a number of occasions and given simple analgesia to no effect.  She denied any history of trauma however she had been a keen dancer for many years.    On further questioning she revealed pain in her mid to lower back for 2 years.  There was no radiation to any limbs and denied any muscle weakness, paraesthesia, incontinence or saddle anaesthesia. 

Her past medical history was only significant for asthma, appendicitis with appendectomy at the age of 14 and buckle fracture of left radius at the age of 9. A salbutamol inhaler was her only medication. 

Neurological exam did not find any abnormality, however she did have bony tenderness over L1-L3.

She therefore underwent Thoracic and Lumbar spine X-rays. Surprisingly she was found to have minimal compression of T11 and T12 vertebral bodies anteriorly but no abnormality at L1-L3 level (Fig 1).  She proceeded to MRI which confirmed the incidental finding of vertebral compression fractures (Fig 2).  There was no obvious cause found on MRI.  There were no degenerative changes in the vertebral joints and no tumours. 

Blood tests including Calcium, phosphate and ALP were normal, as was renal function and thyroid function tests. She was diagnosed with non-traumatic vertebral compression fracture and was treated conservatively with physiotherapy and analgesia and has not since returned to secondary care.      

Non traumatic vertebral compression fractures are common in elderly osteoporotic patients and in patients with primary and secondary bone tumours. However this patient had none of these factors.  One potential explanation is repeated significant forward flexion whilst dancing resulting in unequal pressure on the anterior spinal column.

x ray spine

Fig 1

mri spine

Fig 2

Submit Community Content

If you have orthopedic information that you would like to share with the Orthogate Community, please register/login and submit your news, event, job, article, case or workshop from the Submit Content menu under the My Account area. Learn more!