Non-osteoporotic L4 vertebral compression fracture after low-voltage electrical injury without secondary trauma: A rare case report

Electrical injury is a common occupational hazard; however, vertebral compression fracture caused by low-voltage electric shock in the absence of secondary fall- or impact-related trauma is extremely rare. We report the case of a man in his early 40s who developed severe lower back pain and inability to walk immediately after a 220-volt alternating-current electrical injury at work. He remained conscious and sustained no fall or blunt trauma. Imaging examinations, including radiography, computed tomography, and magnetic resonance imaging, revealed an acute L4 vertebral compression fracture. Dual-energy X-ray absorptiometry showed normal bone mineral density, and no evidence of tumor, infection, or metabolic bone disease was identified. Because of severe persistent pain, marked functional limitation, and concern regarding mechanical progression, open reduction and internal fixation were performed. Recovery was uneventful, and at the 1-year follow-up, the patient had complete pain relief and satisfactory functional recovery. This case suggests that vertebral compression fracture should be considered in patients with persistent focal back pain after low-voltage electrical injury even in the absence of a history of falling or blunt trauma.