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
Wrist drop and muscle weakness of the fingers induced by an upper cervical spine anomaly.
This report presents a case of wrist drop and muscle weakness of the fingers as a false localizing sign induced by stenosis of the upper cervical spine caused by a bony anomaly. ⋯ The pathophysiology of false localizing signs remains controversial; however, we believe that this unusual compression pattern and level had the possibility to induce atypical myelopathies such as drop hand and finger of the unilateral hand in this case.
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Demonstrative case report of two different evolutions in developmental spondylolisthesis. To our knowledge spontaneous sacral doming reconstruction and healing has never been previously reported. ⋯ Sacral doming is secondary to L5 abnormal position regarding to S1. The mechanism of sacral doming looks like as an osteochondritis phenomena. Loss of support of the sacral plateau by sacral rounding may induce high grade spondylolisthesis.
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Case Reports
Symptomatic perineural cyst: report of two cases treated with cyst-subarachnoid shunts.
Symptomatic perineural cysts are rare. Resection and closure of such cysts sometimes results in postoperative neurological deficits and they can recur. We report two cases of symptomatic perineural cysts treated with subarachnoid shunts. ⋯ Cyst-subarachnoid shunts are a useful treatment option for symptomatic perineural cysts.
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Case Reports
PMMA embolization to the left dorsal foot artery during percutaneous vertebroplasty for spinal metastases.
Distal arterial embolization to the foot with PMMA during vertebral augmentation has not been previously reported. We report a rare case of distal PMMA embolization to the dorsal foot artery during ipsilateral percutaneous lumbar vertebral augmentation in a patient with spinal osteolytic metastases. ⋯ PMMA leakage is a complication associated with vertebroplasty and kyphoplasty. Although the outcome of the PMMA embolization to the vessels resolved without sequelae, in our case spine surgeons and interventional radiologists should be aware on this rare complication in patients with osteolytic vertebral metastases even when contemporary cement containment techniques are used.
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Case Reports
C1-C2 instability with severe occipital headache in the setting of vertebral artery facet complex erosion.
An exact understanding of patient vertebral artery anatomy is essential to safely place screws at the atlanto-axial level in posterior arthrodesis. We aim to report a case of erosion of the left vertebral artery into the C1-C2 facet complex with resultant rotatory and lateral listhesis presenting with severe occipital headache. This represents a novel etiology for this diagnosis and our report illustrates technical considerations when instrumenting the C1-C2 segment. ⋯ This study constitutes the first report of a tortuous vertebral artery causing the partial destruction of a C1-C2 facet complex, as well as instability, with the clinical presentation of severe occipital headache. It hereby presents a novel etiology for both the development of C1-C2 segment instability as well as the development of occipital headache. Careful evaluation of such lesions utilizing CT angiography is important when formulating a surgical plan.