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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Rosai-Dorfman disease (RDD) is an uncommon benign histiocytic proliferative disorder commonly involving the cervical lymph nodes and less frequently extranodal sites, including, rarely, the central nervous system, mainly intracranially. Spinal involvement is unusual. RDD is characterized by pathognomonic histopathological features, which are decisive in the definitive diagnosis. We present the case of a 75-year-old lady who presented with an isolated thoracic vertebral lesion. She underwent 3 CT-guided biopsies, all not confirmative for a definite diagnosis, and 2 open biopsies and debulking of the lesion. ⋯ This case demonstrates the challenge in making a diagnosis. RDD should be considered as a differential diagnosis in case of spinal lesion and non-diagnostic biopsy, especially in steroid sensitive lesions. The implications of the case are discussed.
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Review Case Reports
Solitary sacral osteochondroma without neurological symptoms: a case report and review of the literature.
To report a case of solitary sacral osteochondroma without neurological symptoms and describe the en bloc excision of the tumour, as well as review the literature on osteochondroma involving the sacrum. ⋯ This is the 9th case of solitary osteochondroma of the sacrum to be reported, the first to be reported without any neurological symptoms, and third case reported for which en bloc excision was performed.
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XLIF is an increasingly popular procedure that requires traversing the psoas, with the potential risk of injuring the lumbar plexus nerves. Intraoperative neurophysiological monitoring (IOM) is, therefore, critical in this kind of procedures; nevertheless, there were some reports of neural damage. ⋯ A detailed IOM of lumbar plexus branches can determine in real time the proximity of intrapsoas nerves during XLIF.
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The objective of this study was to investigate the outcome of a case series of patients with dysphagia resulting from diffuse idiopathic skeletal hyperostosis (DISH) of the cervical spine who were treated surgically with resection and fusion. ⋯ Diffuse idiopathic skeletal hyperostosis may lead to osteophyte-associated pathologies of the aerodigestive tract. Preoperative investigations with esophageal and laryngoscopic examinations combined with fluoroscopic swallowing tests are essential. Surgical decompression through osteophytectomy and fusion is an effective management strategy in selected patients and should be considered when non-operative strategies have failed.
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Case Reports
Nontraumatic posterior atlantooccipital dislocation associated with atlantoaxial instability.
Nontraumatic posterior atlantooccipital dislocation has only been rarely reported. In the current study, the authors reported an extremely rare case of nontraumatic posterior atlantooccipital dislocation associated with atlantoaxial instability. ⋯ To our knowledge, this lesion has not been reported previously. Anomalies of upper cervical spine may have induced this instability.