European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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Metastatic spine lesions frequently require corpectomy in order to achieve decompression of the spinal cord and restoration of spinal stability. A variety of systems have been developed for vertebral body replacement. In patients with prolonged life expectancy due to an improvement of both systemic and local therapy, treatment results can be impaired by a loosening at the implant-bone interface or mechanical failure. ⋯ Follow-up (median 15 months) using CT and MRI revealed progressive osseous integration of the PU-C spacer in four patients surviving more than 6 months. Results obtained from imaging methods were confirmed following autopsy by biomechanical investigation of an explanted device. From these data, it can be concluded that implantation of the new radiolucent system provides sufficient long-term stability for the requirements of selected tumour patients with improved prognosis.
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Spinal haemangioblastomas are rare, accounting for only about 7% of all central nervous system cases. The case of a 40-year-old woman with a haemangioblastoma arising solely from a cervical sensory nerve root is presented. ⋯ The patient has Von Hippel-Lindau syndrome and a history of multiple solid tumours. The possible role of the Von Hippel-Lindau tumour suppressor gene in the pathogenesis of these neoplasms is discussed.
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Comparative Study
Primary stabilizing effect of interbody fusion devices for the cervical spine: an in vitro comparison between three different cage types and bone cement.
Interbody fusion cages are small hollow implants that are inserted into the intervertebral space to restore physiological disc height and to allow bony fusion. They sometimes cause clinical complications due to instability, subsidence or dislocation. These are basic biomechanical parameters, which influence strongly the quality of a fusion device; however, only few data about these parameters are available. ⋯ In extension, specimens fused with bone cement were most stable. With respect to the primary stabilizing effect, cages, especially the AcroMed I/F cage but also the WING cage and to a minor extent the BAK/C cage, seem to be a good alternative to bone cement in cervical interbody fusion. Other characteristics, such as the effect of implant design on subsidence tendency and the promotion of bone ingrowth, have to be determined in further studies.
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We report a case of 14-year-old male patient with osteoid osteoma of the cervical spine. Magnetic resonance imaging (MRI) revealed a large dumbbell-shaped paravertebral tumor in the region of the exiting left C6 nerve. ⋯ The resected specimen exhibited extensive vascularization of the osteoid tissue. The case is presented because MRI did not allow a specific diagnosis of osteoid osteoma, and suggested the tumor was larger than in reality it was, by also depicting the reactive inflammation around the tumor as if it were part of the tumor.
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Vertebroplasty-percutaneous cement augmentation of osteoporotic vertebrae is an efficient procedure for the treatment of painful vertebral fractures. From a prospectively monitored series of 70 patients with 193 augmented vertebrae for osteoporotic and metastatic lesions, we analysed a group of 17 patients suffering from back pain due to osteoporotic fractures. ⋯ The use of a low-viscosity polymethyl methacrylate (PMMA) in combination with a non-ionic liquid contrast dye provides a reliable and safe procedure. Extraosseous cement leakage was seen in 20% of the interventions; however, none of them had clinical sequelae.