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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Case Reports
CT-guided percutaneous translaminar approach for blood patching: case report and technical note.
In this article the authors describe a novel technique for performing epidural blood patch (EBP) by percutaneous CT-guided translaminar approach in challenging cases where interlaminar approach is not possible. A 24-year-old woman with medical history of multiple spinal surgeries and instrumentations for the treatment of scoliosis, presented 3 months post-operatively with acute and severe orthostatic headaches that began 1 week after surgery. Neurological examination was normal. ⋯ Computed tomography (CT) myelography revealed CSF leakage in the level of T3 vertebra. EBP was attempted using fluoroscopic and then CT guidance; however, despite multiple attempts, the epidural space could not be accessed through the interlaminar route due to extensive instrumentation of the spine and profound structural bony abnormalities. EBP was performed successfully via a CT-guided translaminar approach using an Ostycut trephine needle (Angiomed(®)/Bard, Karlsruhe), without complications.
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Case Reports
Rhabdomyolysis after heterotopic ossification: an unusual complication in a spinal cord injured patient.
Loss of joint mobility, resulting loss of function peripheral nerve entrapment and pressure sores are the known complications of heterotopic ossification. ⋯ We report the case of our patient to increase awareness among physicians and training staff working with patients with a spinal cord injury to expedite the diagnosis of rhabdomyolysis in the setting of HO and SCI.
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To report a case of Veillonella spondylodiscitis in a healthy 76-year-old lady. ⋯ The aim of this report is to bring Veillonella spondylodiscitis to the attention of spinal surgeons and infectious disease specialists and discuss the management options.
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To report a serious complication of the StaXx FX system used to stabilize an osteoporotic vertebral fracture. ⋯ New treatment modalities have their own pitfalls and possible complications, as demonstrated in this case report. Caution regarding implementation of new treatment modalities should be practiced.
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Perineural cysts are believed to be asymptomatic; however, they rarely cause symptoms related to nerve root compression. Cervical symptomatic perineural cysts are in fact exceedingly rare. There are no reported cervical perineural cysts in the literature that present like cubital tunnel syndrome. ⋯ We reported the first cervical perineural cyst as presenting like cubital tunnel syndrome patient in the literature. The visualization of perineural cyst may need extra magnetic resonance imaging (MRI) sections in order to view the nerve root through the neural foramen or extraforaminal area. These lesions are benign, and the appropriate treatment is curative.