• Toru Funayama, Alessandro Gasbarrini, Riccardo Ghermandi, Marco Girolami, and Stefano Boriani.
• Department of Oncologic and Degenerative Spine Surgery, Rizzoli Orthopedic Institute, Via G. C. Pupilli 1, 40136, Bologna, Italy. funatoru3@gmail.com.
• Eur Spine J. 2017 May 1; 26 (Suppl 1): 58-62.

PurposeWe describe a rare case of solitary bone cyst involving the vertebral body of L4.IntroductionTo the best of the authors' knowledge, only 15 cases of solitary bone cysts involving the spine have been reported previously. All the reported cases were treated surgically, including resection and curettage with or without bone grafting. In the current case, treatment was with steroid injection alone.MethodA cystic lesion involving the vertebral body of L4 was identified in a 16-year-old girl with persistent low back pain of 2 years' duration. According to the radiological characteristics of the lesion, a diagnosis of solitary bone cyst was suspected. The patient underwent surgical intervention with percutaneous steroid injection alone since there was no evidence of thinned cortex or pathological fracture. The patient was discharged 2 days after this intervention with resolution of the low back pain.ResultAt the final follow-up 7 months after treatment, the patient was asymptomatic and the beginning of bony healing was evident.ConclusionHerein, we reported an extremely rare case of solitary bone cyst involving the body of the fourth lumbar vertebra. Local steroid injection should be considered as a minimally invasive intervention for a solitary bone cyst involving the spinal column with no evidence of thinned cortex or pathological fracture.

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