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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Hypertrophic craniocervical pachymeningitis (HCP) is a rare disease causing chronic inflammatory hypertrophy of the cranial and spinal dura mater. To increase awareness of this condition, we report the details of a case here. ⋯ HCP can be diagnosed by MRI and laboratory investigations. In this case corticosteroid treatment was effective, although care must be taken when slowly reducing the dose. This case highlights HCP as a cause of progressive cerebellomedullar and cervical spinal cord symptoms.
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Case Reports
Five-level cervical corpectomy for neurofibromatosis-associated spinal deformity: case report.
To describe a successful five-level cervical corpectomy and circumferential reconstruction in a patient with a plexiform neurofibroma causing a severe kyphotic deformity. ⋯ Five-level cervical corpectomy including C2 can be safely and successfully performed via a transmandibular, circumglossal approach. Circumferential reconstruction utilizing a custom anterior titanium cage and plate system manufactured from a pre-operative CT scan was utilized in this case. Long segment occipital-cervical-thoracic reconstruction is recommended in such a case. Using such a technique, improvement in myelopathy, correction of deformity, and improved quality of life can be achieved.
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Comparative Study
Fusion in degenerative spondylolisthesis: comparison of osteoconductive and osteoinductive bone graft substitutes.
The emergent widespread options of bone graft substitutes for spinal fusion procedures vary in their osteobiologic activity. A majority of current literature focuses on the comparison of osteoinductive (OI) or osteoconductive (OC) bone graft substitutes individually against ICBG. These studies have demonstrated the legitimacy of bone graft substitutes, but despite the widespread use in spinal fusion procedures there is a dearth in the current literature in the direct comparison of OC and OI substitutes. This retrospective comparative analysis compares the efficacy of OI vs. solely OC agents in producing radiographic fusion on patients with DS. ⋯ With the vastly growing market for OI and OC materials commonly used in lumbar spinal fusions, the options for surgical treatment for degenerative spondylolisthesis are ever expanding. No significant difference was found when comparing fusion rates between the two types of materials in this retrospective analysis. Interestingly, TLIF procedures provided lower fusion rates than posterolateral fusion procedures. This may be due to a small sample size but the association with a minimally invasive technique warrants investigation. Due to the substantial difference in price between the OI and OC materials and the lack of evidence supporting higher fusion rates with more expensive OI agents, it is incumbent on the spine community to consider and reassess the products that are routinely used.
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To evaluate the safety and efficacy of three-dimensional (3D) navigation-guided polymethylmethacrylate (PMMA)-augmented thoracic and lumbar pedicle screw fixation for the osteoporotic patients. ⋯ The results show favorable outcome using 3D navigation-guided PMMA-augmented thoracic and lumbar pedicle screw fixation for the osteoporosis patients both clinically and radiologically.
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Case Reports
Hyperplasia of rib and vertebra, associated with infiltrating lipoma: a rare case of focal overgrowth.
Syndromes with focal overgrowth are rare and diagnosis is difficult because manifestations are highly variable and symptoms overlap between syndromes. Diagnosis depends on clinical history, physical examination, and radiologic and histologic findings. This report describes a case of focal overgrowth of the left seventh rib and half of the adjacent thoracic vertebra, with overlying infiltrating lipoma. ⋯ We report on a second case of focal overgrowth of a rib and half of the adjacent vertebra, and overlying lipoma. In addition to the first case, we present MR images demonstrating infiltration of the adipose tissue.