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Tophaceous pseudogout of the thoracic spine.

Calcium pyrophosphate dihydrate deposition disease (CPDD, tophaceous pseudogout) is a rare crystal arthropathy characterized by pyrophosphat … ervical junction and skull. Spinal calcium pyrophosphate crystal deposition is rare in the thoracic spine. It is often asymptompatic and can involve the disc or ligaments. This case demonstrates a unique presentation of CPDD.

The spine in β-thalassemia syndromes.

STUDY DESIGN: Literature review. OBJECTIVE: To present a comprehensive overview of spinal involvement in patients with β-thalassemia, aimin … tients with TM, genetic and acquired risk factors lead to osteoporosis, pathologic fractures of the spine, and back pain. Osteoporosis in TM patients is progressive; thus, early diagnosis and treatment are recommended. Bisphosphonates are relatively safe and effective in this patient population. Characteristic intervertebral disc degeneration is also se …

The young adult spine in sports.

In summary, LBP is a common problem for the young adult athlete, with discogenic pain being the most common of all etiologies. Although rare, more serious etiologies such as tumor or infection should be included in the differential diagnosis until effectively ruled out. Regardless of the cause, nonoperative and conservative strategies should be the cornerstone of treatment, owing to the favorable natural history of most LBP etiologies. Short-term non-narcotic medications are helpful, and avoidance of bed rest is critical for the athletic population. Rehabilitation should focus on stabilization

Synovial cysts of the lumbar spine.

BACKGROUND AND PURPOSE: Synovial cysts of the spine occur most frequently in the lumbosacral region. Methods of treatment vary, but in cases of chronic pain or neurological deficits surgical intervention is undertaken. The aim of this paper is to present indications, surgical technique and efficacy of surgical treatment in patients with synovial cyst of the spinal canal. MATERIAL AND METHODS: The retrospective analysis included 11 patients, aged from 47 to 72 years, treated at the Department of Neurosurgery and Neurotraumatology, Poznan University of Medical Sciences, between 2004 and 2009. T…

DEGENERATIVE STENOSIS OF THE LUMBAR SPINE.

This paper presents an update on degenerative stenosis of the lumbar spine, which is a common pathological condition among patients over the age of 65 years. The anamnesis and physical examination need to be precise, since radiography often only provides indirect signs. Magnetic resonance imaging is necessary if the symptoms persist. The treatment for lumbar stenosis is a matter of controversy. However, there seems to be some benefit from surgical treatment rather than conservative treatment, such that surgery brings improvements in symptoms and functions for a period of up to two years.

Imaging of stress fractures of the spine.

Back pain caused by stress fractures, fatigue, or insufficiency, affects varied patient populations based on the level of physical activity and bone mineral density. Stress fractures may involve the vertebral body, pars interarticularis, and the pedicle; often overlooked are stress fractures of the sacrum or bony pelvis, which can mimic pain of spinal origin and delay diagnosis. The choice of optimal imaging (radiographs, nuclear medicine, magnetic resonance imaging, and computed tomography) also depends on the patient population under study and the clinically suspected diagnosis. The diagnosi

[Injection techniques in the cervical spine].

Spinal injections are a treatment option in the conservative management of degenerative spinal disorders. The indications must be critically reviewed for every patient. Treatment with injections for painful spinal disorders should be a part of interdisciplinary treatment regimes. The diagnostic value varies between injection procedures. A large number of imaging techniques are used to achieve a precise and safe needle placement in interventional procedures. The following article presents an overview of common fluoroscopy-guided spinal injection techniques for the cervical spine.

[A case of epithelioid hemangioma of the spine].

Epithelioid hemangioma is a rare and benign vascular tumor, most often occurring in the skin. Numerous other localizations, including bones, have been reported. The overall favorable clinical outcome of cutaneous epithelioid hemangioma is now well documented, but it still remains debated in osseous localization, as local recurrences and metastases have been described. We report a case of epithelioid hemangioma of the spine occurring in a 25-year-old male, and discuss main differential diagnoses. Recent studies tend to demonstrate that osseous epithelioid hemangioma, as cutaneous epithelioid he…

Transoral approaches to the cervical spine.

A number of anterior approaches to the craniocervical junction have been described to allow exposure to the midline and lateral aspects of both the cranial base and upper cervical spine. The transoral-transpharyngeal approach, a technique that is well known to many spine surgeons, provides surgical access to the anterior clivus, C1, and C2. Transoral approaches provide the fundamental anatomy and technique upon which the more complex jaw-splitting approaches are based. This article discusses fundamental concepts regarding anatomy, perioperative considerations, and technical aspects critical to…

Non-pyogenic infections of the spine.

Subacute and chronic spondylodiscitis can be caused by a wide spectrum of infectious aetiologies including Mycobacterium tuberculosis, Brucella spp. and a variety of fungi including Aspergillus spp., Candida spp. and Cryptococcus neoformans. Knowledge of the local epidemiology and prior exposure might suggest the aetiology. Non-invasive diagnostic approaches, such as blood culture or antibody titres in the case of Brucella or antigen detection in the case of fungal infections, can be helpful in reaching the diagnosis. However, direct aspiration or tissue biopsy is usually necessary to identify

Spine injuries in the sport of gymnastics.

Injury in gymnastics is not an uncommon occurrence, and an injury of the spine frequently is a source of pain in a gymnast. Because of the unique demands of this sport, which repetitively place significant forces across the spine, it becomes clear why the spine commonly is injured. Potential causes of back pain in a gymnast include spondylolysis, Scheuermann's disease, intervertebral disc pathology, and mechanical sources of pain. Much of the diagnostic workup and management of spondylolysis lesions remains controversial, but a successful management strategy can be developed for the safe retur…

Tuberculosis of the spine: a historical review.

Almost all ancient civilizations described tuberculous bacilli in their old scripts, and these bacteria have been found in prehistoric skeletal remains. The clinical availability of specific antitubercular drugs was the most important breakthrough in managing spinal tuberculosis. Any attempt at surgical excision of the disease prior to the antitubercular era met with serious complications, dissemination of disease and high mortality (nearly 50%). Antitubercular drugs markedly improved the results of management by operative treatment. Excellent healing of disease was also observed in those pati

Observations on spine deformity and syringomyelia.

OBJECTIVE: Spine deformities, notably scoliosis, are known to occur in conjunction with syringomyelia. This study aims to analyze the effect of laminectomies performed in the course of treatment of syringomyelia. It examines the incidence, severity, and type of spine deformity as it relates to the extent and location of laminectomies performed. METHODS: Records of 169 patients were analyzed for evidence of spinal deformity on imaging studies for the extent of the syringomyelic cavities and for previous surgical procedures on the spine. This analysis included patients with syringomyelia relate…

Cancer in the Spine: Comprehensive Care

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… While there are several books on spines, there are but a few that focus on this specific topic. Cancer in the Spine is a comprehensive and a unique text that clearly meets the purpose of comprehensive care in spinal cancers and provides excellent resources. … It deserves a place in the library of any specialist or institution that is involved in the care of individuals with cancer involving the spine. …

[Hyperextension injuries of the thoracolumbar spine].

A group of 965 patients treated for thoracolumbal spine injury in the period 1998 till 2003 were analysed. 307 fractures were operated on. Out of this number, 4 fractures were type B3 according to Magerl's classification, i. e. 0.21 % of the admitted and 1.31 % of the operated patients. All 4 patients were operated by stabilization with internal fixator and posterior or combined fusion. Fractures were diagnosed in older patients, age average being 63.75 years, with the range of 57-72 years. All patients were obese, average body mass index being 32.75, with the range of 30.9 to 36.4. Fractures …

Thymoma metastatic to the extradural spine.

BACKGROUND: Spinal epidural metastases are the most common spinal tumor, occurring in 10% of cancer patients. Malignant thymoma is a mediastinal tumor, with extrathoracic metastases occurring in 15% of patients to liver, kidney, and bone. Spinal metastasis is exceptionally rare. We present a case of thymoma with extradural metastasis and discuss the relevant literature. CASE REPORT: We describe a 45-year old man presenting with back pain and hypoesthesia twelve years after a diagnosis of thymoma. A review of the literature reveals few cases of thymoma metastatic to the extradural spine. We de…

[Treatment of racemose neurocysticercosis of the spine].

INTRODUCTION: Neurocysticercosis (NCC) is the most frequent parasitic infection of the central nervous system, and its prevalence is high in … arachnoiditis has a poor prognosis and is often untreatable. The therapeutic options in NCC of the spine are discussed, and attention is drawn to the importance of cysticercotic arachnoiditis in the prognosis of the disease.