Lumbar intervertebral disc ossification complicated by lumbar vertebral compression fracture: a case report

Central ossification of the intervertebral disc in adults is an extremely rare pathological condition, and concomitant lumbar vertebral compression fractures have rarely been documented in clinical studies. Herein, we report a rare case of lumbar disc ossification complicated by vertebral compression fracture. An 81-year-old woman presented with unexplained severe pain localized to the L1 segment and restricted mobility. Computed tomography (CT) demonstrated collapse of the L1 inferior endplate as well as an ossified hyperdense lesion within the central portion of the L1/2 intervertebral disc. Based on her medical history, physical examination, and imaging findings, a diagnosis of L1 compression fracture was established. Under local anesthesia, percutaneous kyphoplasty (PKP) was performed for the L1 fracture. Intraoperatively, tissue samples were harvested from the L1/2 intervertebral disc lesion for biopsy. Histopathological analysis of the biopsy specimen confirmed intervertebral disc ossification. Postoperative CT revealed satisfactory bone cement dispersion within the L1 vertebral body, accompanied by marked relief of L1-segment pain. The exact pathogenesis of lumbar intervertebral disc ossification remains unclear. Large-scale central ossification of the lumbar disc is relatively rare in adult patients, and secondary compression fractures of the adjacent vertebral body caused by disc ossification are even less frequently reported. This case report aims to deepen the clinical recognition of this rare condition, reduce missed and misdiagnosed cases, and provide evidence for further in-depth studies on its pathogenesis and clinical management.