Abstract

A case of vertebral necrosis of L4 is reported in a young woman without previous steroid therapy. Only the intraoperative histological examination was able to confirm the diagnosis as a benign vertebral collapse, because the CT scan and MR imaging were suggestive of a malignant involvement. The authors report the various criteria proposed to distinguish benign and malignant vertebral collapse with magnetic resonance imaging. These equivocal criteria should be viewed within the context of tissue replacement within the necrotic area during the evolution. Transpedicular biopsy is emphasized. Only the histological examination is specific and allows right planning of the surgical procedure.