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case_images: (A, B): Anteroposterior (A) and lateral view (B) radiographs illustrating a distinctive lytic lesion positioned at the right inferior articular process of L3.
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case_images: X-rays (Fig. 1), requested six months prior to diagnosis, displayed a lytic image on the right inferior articular process (IAP) of L3 and a left convex scoliotic posture.
case_images: (A, B): The MRI depicted edematous signal abnormalities in the right lateral and posterior arches of the L3 and L4 vertebrae, characterized by hyperintensity on T2 and STIR sequences and hypointensity on T1. Post Gadolinium injection, these signals exhibited homogeneous enhancement. The abnormalities were centered on the ipsilateral posterior zygapophyseal joints, notably enhancing the right L4 zygapophyseal joint space, and extended into the right lumbar psoas and paravertebral muscles, without evident collections.
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case_images: Due to the lack of improvement, the patient sought our consultation, leading to an MRI (Fig. 2) showing an edematous signal abnormality in the right lateral and posterior arches of the L3 and L4 vertebrae.
case_images: (A, B, C): CT scan showing a well-defined lytic lesion located at the right inferior articular process of L3, extending to the inferior articular surface of L3 and the adjacent superior articular process of L4. The lesion includes a calcified nidus causing cortical disruption, surrounded by osteocondensation with blurred borders.
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case_images: A CT scan (Fig. 3) unveiled a well-defined lytic lesion centered on the right inferior articular process of L3, extending to the inferior articular surface of L3 and the adjacent superior articular process of L4.
case_images: Specimen radiograph (A) and Postoperative X-rays depicting the extent of resection and successful placement of pedicle screws, as seen in the anteroposterior view (B) and lateral view (C).
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case_images: To address potential instability following the resection, unilateral fixation with pedicle screws at L3-L4 was performed (Fig. 4).
case_images: A. Low-power view of Osteoblastoma with a well-defined tumor border. The bony lesion is encircled by a sclerotic rim and consists of inter-anastomosing trabeculae of woven bone within a loose, edematous fibrovascular stroma. (Hematoxylin and eosin stain, magnification x40).. B. Bony lesion composed of inter-anastomosing trabeculae of woven bone, set within loose edematous fibrovascular stroma, with extravasated erythrocytes. (Hematoxylin and eosin, magnification x100).. C. High-power view of Osteoblastoma: Osseous trabeculae bordered by a single layer of activated osteoblasts within a loose, edematous fibrovascular stroma. (Hematoxylin and eosin stain, magnification x400).. D. High-power view of Osteoblastoma showing scattered osteoclast-type, multinucleated giant cells (black arrows). (Hematoxylin and eosin stain, magnification x400).
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case_images: Histological examination confirmed the diagnosis of osteoblastoma (Fig. 5).