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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Review Case Reports
What are MRI findings of Spine Benign Metastasizing Leiomyoma? Case report with literature review.
Benign Metastasizing Leiomyoma (BML) is a rare disease that results from metastasis of uterine leiomyoma to distant sites with benign pathologic features. Spine BML is very rare so the information of its features and pathophysiology is seldom known. ⋯ We gathered the fragmentary information of the spine BML for the first time, especially the MRI findings. Although spine BML is rare, it surely exists. Accordingly, spine surgeons should be suspicious of spine BML given its typical clinical history and MRI findings.
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The cranio-cervical junction (CCJ) is an anatomically, functionally and biomechanically complex region. It is commonly involved in trauma of varying severity that can be managed with a multitude of treatment options and carry diverse prognosis. Our objective is to evaluate the quality of currently used CCJ injury classifications in an evidence-based approach. ⋯ CCJ injuries are poorly described by the current classifications according to evidence-based criteria. There is an obvious need for a simple and reliable classification tool to guide patient management in the evidence-based medicine era.
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Case Reports
Rupture of the spleen following thoracoscopic spine surgery in a patient with chronic pancreatitis.
To highlight the perioperative risk of intracapsular haematoma of the spleen or splenic ruptures during thoracoscopic spine surgery in patients with chronic pancreatitis. ⋯ Due to its proximity to the thoracolumbar junction, the spleen is vulnerable to injury during spine surgery. If the patient has undergone previous intra-abdominal operations or chronic inflammation of the pancreas is found, special care of the spleen during the operation is necessary.
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We report on a patient with an unusual cause of non-discogenic sciatica. ⋯ The present case suggested that an intrapiriformis lipoma can cause secondary piriformis syndrome and medical practitioners should be aware of this condition and consider lipomas and other occupying lesions of the pelvic muscles as a differential diagnosis in patients presenting with radicular pain.
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Septic cervical facet joints arthritis is a rare pathology, usually revealed by fever and neck pain. As symptoms may be indolent, a high index of suspicion needs to be maintained. Magnetic resonance imaging (MRI) is effective for early diagnostic, looking for local spread and guiding potential preoperative planning. We present a case exhibiting an uncommon pathology with possible significant morbidity if misdiagnosed. ⋯ Atlantoaxial septic arthritis is an under reported and severe infection. Early use of MRI should avoid delayed diagnosis and would guide the practitioner in choosing an appropriate therapy. Early surgical treatment for uncontrolled sepsis is also a critical element of the prognosis.