背景：纤维发育不良（FD）是一种常见的良性髓内纤维骨病变。脊柱的参与是罕见的，文献只包括病例报告，骶骨单骨FD（MFD）的病例极为罕见。脊柱MFD的正确术前诊断对于临床医生选择正确的治疗方法很重要。
方法：我们回顾性评估了一例骶骨MFD的病例报告。该患者通过计算机断层扫描（CT）和磁共振成像（MRI）检查，经病理证实。对文献进行了回顾，以分析脊柱MFD的影像学特征和鉴别诊断。对我们的病人来说,CT扫描显示病变是扩张性的,有毛玻璃混浊和硬化边缘。核磁共振成像,病变在T1WI上表现为低信号强度，在T2WI上表现为高信号强度。在T1WI和T2WI上发现了低信号边缘。我们的病人接受了后部局灶性切除术，减压,骨移植,融合和椎弓根螺钉固定。取得了满意的效果,疼痛消失。随访1年无并发症发生。
结论：MFD是一种膨胀性溶骨改变。毛玻璃混浊和硬化边缘是明显的特征。病变通常涉及椎体和后部元件。了解脊柱FD的这些影像学特征可能有助于诊断和防止不必要的手术。
BACKGROUND: Fibrous dysplasia (FD) is a common benign intramedullary fibro-osseous lesion. Involvement of the spine is rare, with the literature including only case reports, and cases of
monostotic FD (MFD) in the sacrum are extremely rare. A correct preoperative diagnosis of spinal MFD is important for clinicians to select proper treatment.
METHODS: We retrospectively assessed a case report of MFD in the sacrum. This patient was examined by computed tomography (CT) and magnetic resonance imaging (MRI), and the diagnosis was confirmed by pathology. A review of the literature was performed to analyze the imaging characteristics and differential diagnoses of spinal MFD. For our patient, the CT scan showed the lesion to be expansile, with ground glass opacity and a sclerotic rim. On MRI, the lesion showed iso-low signal intensity on T1WI and iso-high signal intensity on T2WI. A low signal rim was found on T1WI and T2WI. Our patient was treated by posterior focal excision, decompression, bone grafting, fusion and pedicle screw fixation. A satisfactory result was achieved, with pain disappearance. No complications had occurred at the 1-year follow up.
CONCLUSIONS: MFD is an expansile osteolytic change. Ground glass opacity and a sclerotic margin are obvious characteristics. The lesion often involves the vertebral body and posterior element. Knowledge of these imaging characteristics of spinal FD could be helpful for diagnosis and prevent unnecessary procedures.
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